**2. Antecedents / background**

Improvements in medical technology and healthcare have helped people to live longer and with a better quality of life. Nowadays, our societies are facing new challenges in terms of economically and socially supporting their ever more costly welfare systems and increasing elderly population and chronic patients. The future of health care provision will see an exchange from centralized health care services, provided in doctors' offices, clinics, and hospitals, to ubiquitous and pervasive health monitoring in everyday life. The reason for this development is twofold. Firstly, demand for better, more comprehensive and proactive health care and health provision is steadily increasing. Long-term unobtrusive monitoring of biomedical signals to enable early-stage diagnosis of health issues represents a key component in proactive health care. Secondly, there is the requirement to mitigate increasing health care costs caused by the demographic changes of an aging society. By providing health services at a patient's home where the cost is lowest (as opposed to expensive clinical environments), large cost reductions seem to be feasible while at the same time providing a better quality of life [9]. New medical technologies and improvements in health information systems have benefited medical supply ordering and management, patient record administration, medical diagnosis, and the provision of patient services [10].

In recent years we are seeing great advances in all areas of technology from low-power electronics, Short Range Devices and sensor technologies to the development of new and original wired and wireless communication. These advances have already led to the develop‐ ment of new small-sized wireless medical and environmental sensors that are capable of monitoring the human body as well at its environment in a more efficient way. These advances in sensing, communication technologies and in software engineering make it possible to build new solutions for wearable healthcare systems and ubiquitous healthcare smart homes. With these systems, elderly people and those with pre-existing health conditions can remain in their own home, while healthcare providers can remotely monitor and advise them to improve their well being and provide them with quality healthcare.

Wireless connectivity is a feature of IoT, and is becoming increasingly used in AAL systems with intensive use of Short Range Devices (SRD) such as Radio Frequency Identification (RFID), Ultra Wide Band (UWB), Near Field Communications (NFC), Wireless Local Area Networks (WLAN), Bluetooth, ZigBee, telealarm buttons (social alarms) or domotic devices. These systems involve sensors, computing and communication devices working in increas‐ ingly dense electromagnetic environments. One emerging approach to improve the wearabil‐ ity of continuous ambulatory monitoring systems is to improve body-attached sensors with built-in wireless telemetry, thus freeing the user from having to carry a data recorder.

For these telemetry systems, it is likely that a large number of wireless links coexist in the same area sharing the electromagnetic (EM) environment [8]. Electromagnetic Fields (EMF) are present everywhere in our environment and will continue to increase. In this way, our environment will be surrounded by multiple mobile and stationary devices, communicating wirelessly, and working together. The level and frequency pattern of that exposure is contin‐ uously changing as technological innovation advances. Exposure to the general public cannot be avoided, since various devices emitting low-level EMF are almost omnipresent in the environment, including wearable devices attached to clothes or directly to the body. Electro‐ magnetic Interference (EMI) can be a serious problem for any electronic device, but working with medical devices can have life-threatening consequences. Practical commercial deploy‐ ment of these wireless networks requires measurements of the Electromagnetic Compatibility

(EMC), as a guarantee of lack of interferences 24 hours a day, seven days a week.

Improvements in medical technology and healthcare have helped people to live longer and with a better quality of life. Nowadays, our societies are facing new challenges in terms of economically and socially supporting their ever more costly welfare systems and increasing elderly population and chronic patients. The future of health care provision will see an exchange from centralized health care services, provided in doctors' offices, clinics, and hospitals, to ubiquitous and pervasive health monitoring in everyday life. The reason for this development is twofold. Firstly, demand for better, more comprehensive and proactive health care and health provision is steadily increasing. Long-term unobtrusive monitoring of biomedical signals to enable early-stage diagnosis of health issues represents a key component in proactive health care. Secondly, there is the requirement to mitigate increasing health care costs caused by the demographic changes of an aging society. By providing health services at a patient's home where the cost is lowest (as opposed to expensive clinical environments), large cost reductions seem to be feasible while at the same time providing a better quality of life [9]. New medical technologies and improvements in health information systems have benefited medical supply ordering and management, patient record administration, medical diagnosis,

In recent years we are seeing great advances in all areas of technology from low-power electronics, Short Range Devices and sensor technologies to the development of new and

**2. Antecedents / background**

142 Telemedicine

and the provision of patient services [10].

Over the last few years, the number of short range systems has increased in residential environments. These systems provide a great variety of emerging applications such as tracking and mobile telecare and welfare, with the possibility of the inclusion of many types of conventional alarms (gas, smoke, flood, etc...). Short Range technologies provide direct benefits when applied to a healthcare environment. The main objective of these SRD is to communicate emergency situations due to domestic accidents or health emergencies. These are low-cost information gathering and dissemination devices and facilitate fast-paced interactions among objects themselves (vehicles, cell phones, habitats, habitat occupants), as well as the objects and people in any place and at any time [11]. The special implication of these devices with welfare and safety requirements involves a special interest in its operating conditions as well as in promoting correct habits of usage.

With the rapid advances in increasing computational performance while allowing for ever smaller integration sizes, on-body networks of wirelessly connected computing devices is becoming a reality. The vision of ubiquitous health (U-Health) care is addressed by this Body Area Network (BAN) and Body Sensor Network (BSN) technology [12]. As is shown in Figure 1, a network of interconnected Wireless Sensor Nodes (WSNs) in or around the body monitors a range of biomedical signals to assist in the detection and diagnosis of health - related problems.

In the emergent IoT approach, a wide range of SRD is used. Smart applications and services to cope with many of the challenges individuals and organizations face in their everyday lives, such as environmental and personal health remote monitoring systems. These applications would change the way societies and especially our healthcare system function and thus would have a big impact on many aspects of people's lives in the years to come. IoT is not a mere extension of today's Internet or Internet system. It represents intelligent end-to-end systems that enable smart solutions, and, as such, covers a diverse range of technologies, including sensing, communications, networking, computing, information processing, and intelligent control technologies. Furthermore, technical advances in miniaturization and wireless communications have enabled applications of wireless sensing and biomonitoring, using devices that are now available for general use by healthcare professionals, patients and caregivers [7], [9].

These solutions could significantly reduce the cost of welfare systems while maintaining existing hospitals and dedicated centers for people who cannot benefit from these Information and Communications Technology (ICT) solutions. U-Health Smart Home, a home equipped with ICT to support people directly in their homes, has been identified by governments and

communication networks and implanted electric devices. The second is the compliance with exposure levels threshold, to quantify and analyze the risk of exposure caused by the use of

Short Range Technologies for Ambient Assisted Living Systems in Telemedicine: New Healthcare Environments

http://dx.doi.org/10.5772/57020

145

For some years now short range technology has been considered a very promising option to cope with healthcare monitoring challenges. Consequently, this work aims to show the new technological advances and which factors might explain the penetration rate in healthcare. The appearance of smart phones has been the major developmental breakthrough in the field of wireless personal area networks (WPAN). This has conditioned to a large extent the proliferation of devices in AAL systems that use the aforementioned smart Phones as a

Factors like, accessibility, price, processing and communication capacity, as well as the use of cameras, navigation systems, such as the Global Positioning System (GPS), and accelerometers allow for a great flexibility in the development of further applications. The increasing use of operating systems, such as, Android, iOS, Symbian or Windows Phones that use the Software Development Kit (SDK) allow the development of certain applications to became easier and easier. As a result, networks that are compatible with the smart phones (Bluetooth, Wi-Fi o NFC) are currently the most frequently used by devices that are found within personal area

Within the area of AAL three types of wireless networks need to be considered, Wi-Fi networks, domestic networks and networks made up of social alarm devices (SAD). Wi-Fi networks because of their widespread usage, reduced price and operability with other such as PCs, tablets or smart phones are a very attractive proposition for network usage within assisted environments, without forgetting their main advantage, that of internet access. Disadvantages

With regard to SAD, they are perhaps today the most frequently installed device within elderly households. Within Spain it is estimated that there are currently around 300.000 SAD and that 4% of Europeans of more than 65 years of age, have access to a device of this type [14]. The platforms of SAD are suitable for integration with other devices within the assisted environ‐ ments. SAD work on a frequency of 869.2-869.25 MHz and operate under the guidelines of the Commission Implementing Decision of 8 December 2011 (2011/829/EU) [15]. Currently, as well as wristband and chain alarms there are devices to detect falls, to monitor lifestyle, to monitor biological parameters, to detect technical alarms (such as smoke alarms, flood alarms or gas

Within the household wireless systems the Z-Wave technology stands out. In comparison to Wi-Fi, the device runs on batteries and the speed of transmission is lower, from 9.6 Kbps to 40

As is shown in Table 1 with regards to the possible wireless communication options the vast majority use Bluetooth for data communication, differentiating between those that use the conventional form of Bluetooth and those using the newer low consumption version. You can see that there are several devices that are certificated by Continua, which ensure compatibility

could be the high energy consumption and time required to establish a connection.

emissions), medicine dispensers and many other systems and technical aids.

Kbps. Z- Wave operates in Europe on a wavelength of 868 Mhz.

these devices.

**b. Current state of knowledge**

gateway to the network.

networks in the healthcare environment.

**Figure 1.** Ubiquitous health monitoring: a Body Area Network (BAN), wireless sensor nodes, monitoring biomedical signals and remote health assistance (WRTF: wired telephony service)

medical institutions as an important step toward financial savings, as well as a technologically and socially acceptable solution to maintain the viability of the welfare system. However, there are several obstacles to the acceptance of these solutions, some are technological, and others are more related to human acceptance in terms of comfort and business value.
