e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

A New Web-based E-health Platform

Noura BACCAR Ridha BOUALLEGUE

Innov’Com laboratory, Sup’Com, University of Carthage Innov’Com laboratory, Sup’Com, University of Carthage
Tunis, Tunisia Tunis, Tunisia
[email protected] [email protected]

Abstract—Nowadays, the development of e-health concept is From sensors design [4] and signal processing algorithm to
offering various aspects. In this paper, we present a novel website platform design, various works [5, 6] discussed the application
architecture. Designed for an e-health platform based on a wireless and the ease of use on real world conditions of such systems.
sensor network (WSN), this website offers the ergonomic and Furthermore, studies have covered aside patient monitoring as
multi-functions opportunity for an ambient intelligent hospital. It referenced in the survey [7] about the Wireless Body Area
enables the management of patients’ records, real time patient’s Networks (WBAN), patient tracking and localization[8,9].
state monitoring based on remote sensing of biometric signals as Additionally, security of medical data and personal health records
well as indoor geo-localization for either in or out patient and have been discussed [10]. L. Sun et al. in [11] proposed a cloud
professionals. Using architecture based on combined approach, this
computing semantic approach to control access on e-health
website presents a part of a big e-health project development.
applications. Some works presented an integrated system [12]
Keywords; e-health; website;WSN;remote sensing; localization combining monitoring of patient’s state and the indoor
localization concept without describing the Human-Machine
I. INTRODUCTION Interface (HMI) architecture.
Can technology make sense without human well being? This However, few works on e-health system design have
is question is behind most humanitarian inventions. People developed the Graphical User Interface (GUI). In this paper,
appreciate inventions that facilitates them life but what about working on a multi-functions and ergonomic website is the
medical inventions that decrease the pain level, enhance the body challenge. Some sites were dealing only with managing medical
performance and in most times save from death. records [13]. The Swiss website ―Swisscom‖, using its
Telecommunications have always intended to build more application ―evita‖[14] provides, in addition of that, an e-Alarm
comfortable life style. Moreover, it is taking a pioneer role in system that provides emergency calls. However, it doesn’t give
health care. either localization of the patient or real time signal monitoring.
On the other hand, the ―Isansys‖[15] system which offers real
E-health is the best example where taking care of ill people is
time monitoring of the patient vital signals and many interesting
becoming wireless and homely conducted. Nowadays, we usually
services doesn’t offer mapping and localization for out-patient
hear those words ―intelligent hospital, automated building, home
(patient not resident in the hospital).
automation‖…and we are seeing more and more applications
dealing with this field. E-health as defined by the World Health In this work, the developed website intends to communicate
Organization(WHO) is ―the use, in the health sector, of digital e-health to not only the in-professional (professional working in
data—transmitted, stored and retrieved electronically—for the care center) and the in-patient (patient resident in the care
clinical, educational and administrative purposes, both at the center) but also offers services to out-professionals (professionals
local site and at a distance‖[1]. from outside the care center like: Private doctors, Pharmacist,
Radiologist,…) and out-patient by providing statistical reports for
The WHO-Regional Office for the Eastern Mediterranean
researchers and mapping for any new service demander, guiding
has presented a statistics, on 2005, ranking countries that are
him to the desired direction.
more likely to introduce e-health applications. And Tunisia,
between 127 countries, was indexed number nine [2]. This is This paper is organized as follows: Section 2 presents the
motivating for us to make more and more innovation on the e- general functioning and the use case diagrams. Section 3
health field. illustrates the proposed application architecture. In Section 4, we
present the implementation details and some developed
Wireless Sensor Networks didn’t miss innovations on e-
interfaces. Section 5 concludes the paper.
health. Their application in the e-health field is studied with
different aspects. Alemdar et al [3] published a survey presenting II. APPLICATION OVERVIEW
the art state of different used technologies (Zigbee, Wi-Fi,
RFID…) and prototypes developed by researchers. The e-health platform is a whole independent system which
carried various functionalities. Allowing, not only monitoring
patient’s records but also gives real time vital signals processing
These works of research and innovation are made within a MOBIDOC and positioning of in-patient. Thus such platform includes
thesis, financed by the European Union (EU) within the framework of the various actors and validates different needs inside a care-center.
PASRI program and partially supported by Cynapsys IT Enterprise.

978-1-4799-5041-6/14/$31.00 ©2014 IEEE 14

 e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

Thus, for each actor a use case diagram was established. Fig.2
presents the global use cases including actors and general related
tasks without the communication details between them.
B. Scenarios:
Different scenarios are developed to enhance the website
diversity. Corresponding to each use case diagram, special
scenarios were established. In this paper, we will present some
scenarios as examples.

Modify Medical records

Figure 1. Main Board for e-health platform

Based on Wireless Body Area Network (WBAN), this Real time vital signal
platform uses gathered data from portable biosensors of the monitoring
patient. Remote sensing leads to identify his position.
As shown in Fig.1, using a Zigbee modules, sensors Consult alerts of
In-Professionals urgent cases
communicate with the main board and the Data Acquisition Unit
allows the processing of those signals. Thus, it calculates the
location of patients besides of physiologic data tele-monitoring. Localization Log in
The protocol Zigbee is based on IEEE 802.15.4 standard. The
choice of this protocol was taken relatively to various criteria. Add medical records
First, IEEE 802.15.4 offers data rates at 250kb/s at ISM of new patients
(Industrial, Scientific and Medical) 2.4GHz band which satisfies
Administrator
healthy environment conditions and acceptable rates. Second, Manage professional’s list
Zigbee is characterized by its scalability, which perfectly
responds to the high number of communicating modules in the
hospital scenario. Besides, this technology is known with its Manage the access right
battery autonomy (years), hence reducing the maintenance cost of to medical records

the platform. And finally, its coverage (up to 10-20m) is

sufficient to let patients freely moving under continuous Manage hospital data
supervision.
The main board uses in the other side Wi-Fi modules to Manage medical record
transmit processed results to the final terminals.
Log in
This system allows interaction between various actors:
Give right access to
Hospital administrator, In-healthcare professionals (Doctors, professionals
Patient
nurses, caregivers), Out-healthcare professionals, in-patients, out-
patients.
Manage medical record
In this paper, we will present the development of the
―Human-Machine Interface‖ (HMI). Called ―E-health Center‖,
the developed website transforms the results processed by the Subscribe
platform. Thus, it acts as the ergonomic interface of the wireless
sensors network. Ask for access to a
medical record
A. Use case diagrams
This website gives three main functionalities:
Consult medical records Search
 To manage patients records: Add/ delete and modify Out-health
diagnostics for existent health file. Professional

 To follow the vial signals progress of patients Send tests and analyzes
(Temperature, blood pressure and cardiograph results
pulses) in real time.
 To localize patient and professionals and mapping
service for out-patient
Figure 2. General use cases Diagram

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 e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

Patient The System

Health professionals The e-health system
Display home page

Look for patient Record

Display access Consult access demand
demand list list
Displaying general profile

Sending Access Select a demand

Authentication Display the profile of
the selected doctor
Saving Request & waiting for
patient authorization

Save Delete the

Figure 3. Sequence diagram of the use case : professional access request modifications demand

To guarantee the secured functioning of our website, the

access right management was made based on access priority.
The following diagram shows the behavior of the system when
an access request is received. The system can not authorize the Figure 5. Sequence diagram for patient access validation
professional access without the patient acceptation. Fig.3
illustrates the protocol of communication between the which supplies a particular abstraction of the system to the top
professional and the system. layers.
Furthermore, to simulate the communication between the Every layer possesses specific roles. In a structuring by
wireless sensors network for patient’s supervision and the layers, the lower layers offer a basic functioning for top layers,
professionals, the system has to get back the recorded data in the allowing afterward abstracting the implementation of these basic
real time database as presented in Fig. 4. If any anomaly is services. So, we adopted a division in five layers. Such
detected, the system alerts the professional in charge of its architecture also allows obtaining a good level of re-use and
information. reconfiguration. Those layers are as follow:
For the patient, fig. 5 describes the access validation process a) Presentation layer: This layer contains the e-health
to his record. platform components which have to interact with the user of the
application, as the web pages, the forms, as well as validation
III. PROPOSED SYSTEM ARCHITECTURE
patterns that manage the behavior of the user interface.
A. N-tier architecture and MVC model b) Application layer: Its main purpose is to supply specific
1) N-tier architecture: services in the Presentation layer. These services correspond to
Among various manners to structure architecture, best the business rules defined during the analysis phase. It manages
included and mastered in computing is the approach multi- different control aspects of the use cases described partly in the
layering. A layer is a logical, horizontal division of the system previous section. The communication with the top layer is made
through managed-beans.
c) Services layer: This layer receives the requests of the
WSN E-health System application layer and process the business logic contained in
Health
professionals these requests. It is a package which contains the requested
classes, on one hand, to guarantee the semantic validation of the
business information, and on the other hand, to manage the
Loop interaction with the database. The communication with the
Application layer is made through the services interfaces.
1: Send Signals 2: Signal
processing
d) Domain layer: This layer is certainly one of the most
important. Here are the basic features which allow creating,
opt
searching, modifying and deleting the business entities respecting
3: Alert professionals
with patient’s state the transactional properties. It is also in this layer that the
4: Ask for data mechanisms of conversion object/relational partially take place.
displaying 5: Received data e) The Persistence layer: This layer is responsible of the
6: Patient localization physical storage of data. It insures the transactional support. As
7: Map for
localization regards to our system, this layer will be based on the relational
model.
Figure 4. Sequence diagram of the use case: ―patient vital signal monitoring
and localization‖

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 e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

2) MVC Model2 :
The Model-View-Controller organizes the Human-machine
interface of the software application in a model (business object,
data model), a view (presentation, user interface) and a controller Tasks Data access
scheduling
(control logic, events management), each having a precise role in
the interface. This pattern design imposes the separation between
the data, the presentation and the processing, what gives the three Persistent
object
fundamental parts:
Business

a) The Model: It describes or contains the recorded processing

medical data and the registered measures of the sensors. It offers

updating methods to data (insertion, deletion, values change) of
the database. It also provides methods to get back these data. The
results sent back by the model are divested of any displaying. It is
the model which contains all the business logic of the application.
b) The View: It presented the data sent by the
model.besides, It receives the user tasks and transmit them to the
controller. The view doesn’t proceed to any processing, it is just Figure 6. Packages diagram
displaying the model’s results.
All the application classes are included in the package
c) The Controller: It analyzes the customer request and 'com.ehealth'. We organized the system in packages detailed in
contents with calling the adequate model and with sending back Table 1 to better structure it and facilitate the understanding of its
the view corresponding to the demand. The MVC2 model features.
integrates a front controller which role is to distribute actions to
a specialized subcontroller.
b) Components diagram:
In this work, we combined the two patterns in the same We decomposed the e-health platform on 4 sub-systems
architecture in a way that the user action is got back by the View explained in the diagram of Fig.7.
which asks the Controller for the adequate action. The
Controller reaches the business rules on the application layer to
have access to the logic of the application. The business part can TABLE I. ROLES OF DIFFERENT PACKAGES
have access to the data of the database or other one through the Packages Role
data part. Thanks to this processing, the Controller can then
format the Model via the data of the business part and sends it to Package IHM It describes the relations between the actors of the
system and the engine. Indeed, two actors of the
the View. Thus, we have the MVC model within the system, the researcher and the administrator have
Presentation layer of the n-tier architecture. the possibility of contacting the engine through a
page of welcome or indexation for the researcher,
or page of administration for the administrator.
B. Diagram design: Package Bean It contains the classes of businesses processing and
of data manipulations given by the user via the
To highlight the static architecture of our application, we IHM and those transferred from the database by the
will begin by a general illustration of the solution through the DAOImpl package.
packages diagram. Then, the diagram of classes. DAOImpl package It allows the manipulation of the database. It offers
the basic features which allow creating, searching,
a) The packages diagram: modifying and deleting business objects
Fig. 6 illustrates the logical architecture showing the various components in the database.
packages and the relations between them. Objets package This package contains persistence classes and the
mapping files which are XML files that allow
Hibernate to make the link between the Java
objects and the database.
scheduler Package It contains the classes which check the sensors
values got back by the DAO package in real time
every 5 minutes. It calls in the Bean package for
the alert when anomalies affecting patients is
detected.

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 e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

Access

Identification Indoor
Management of Localization
Medical records

Patient state Simulation of Wireless

Doctors Sensor network

Management of Patients
Staff services State
surveying

Wireless Sensor Network

Figure 7. components Diagram Figure 8. The homepage of the E-health plateform

c) Classes diagram IV. IMPLEMENTATION DETAILS

Fig.9 below illustrates the classes diagram represented
under package "com.ehealth.objects". The package contains
javabeans used to save data. The latter assure the A. Software configuration:
communication with the various tables of our database. Every The technological choice was based on rapidity,
class of this package contains a set of attributes similar to the interoperability and ergonomic criteria. Thus, the development of
existing fields at the level of the bases’s table. These classes also our application leans on the platform J2EE (Java2 Enterprise
contain the methods setter and getter relative to every attribute Edition), JSF, Hibernate and Quartz.
which allow the modification and the recovery of the attributes B. Human-Machine Interface (IHM):
values.
In this part, we present some French interfaces of the realized
work. The homepage in Fig.8 includes all links towards all uses
cases such as connection, registration, search….

Include
Care center File
Folder To Professional
Postulate have

Treat

Professionals’ notes

Add

Doctor
Writing

Figure 9. Classes diagram

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 e-Health Pervasive Wireless Applications and Services (eHPWAS'14)

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