Design and Development of an m-Health Multi-Conference and Multi-Platform Application

Rodrigo Belisário Ramos, Fernando Santana Pacheco,

Leandro Schwarz DAELN/IFSC

Federal Institute of Santa Catarina Florianópolis – SC – Brazil

Begoña García Zapirain ESIDE/Universidad de Deusto

Deusto University Bilbao – Vizcaya – Spain

Abstract— The objective of this project is to design and develop a multi-conference and multi-platform application for phones as an m-health system, to improve the communication between healthcare providers and healthcare recipients, to eliminate the obstacles of distance, providing faster and specialized services to people living in remote areas. There is a variety of operating systems for smart-phones on the market. This project focus on Apple iOS, Android or BlackBerry-playbooks, as they are the most commonly used operating systems, nowadays. Currently the system was tested on Android smart-phones and it showed stable providing text and video communication between two individuals.

Keywords-m-Health; multi-platform application; video-conference, home care

I. INTRODUCTION

Considering the changes in hospitals and other healthcare facilities in the past years, technology and healthcare have become two intertwined fields.

Besides the technological equipment, healthcare constantly uses information and communication technologies (ICTs), like computers, mobile devices and satellites, to provide accessible, cost-effective and high-quality healthcare services [1]. The overall term for this, used by the public health community, is e-health (electronic health) [2].

The fast growth and improvement of mobile communication systems and the growing need to be able to process, send and receive information more rapidly, helped to form an important sub-segment to e-health. In the last years m-health (mobile health) has emerged as an arm of e-health [3]. Both are linked as their technologies work in conjunction and are used to improve health outcomes. Compared to e-health, m-health focuses on the use of mobile communication devices, such as mobile phones and PDAs (Personal Digital Assistant), for communication between healthcare workers and/or patients in order to suppress the obstacles of distance. “It involves using wireless technologies […] to transmit and enable various e-Health data contents and services.” [1].

This is a very important fact to regard, considering that while infrastructural systems like roads, public transportation and healthcare in many rural areas of the developing countries

still are either only poorly developed or barely existing, an “explosive growth of mobile communications over the past decade” can be seen in the same countries [2].

According to the International Telecommunication Union (ITU), access to mobile networks is now available to 90% of the world’s population and to 80% of the population living in rural areas [4]. In fact, with 5.9 billion of mobile-cellular subscription, global penetration reaches 87%, and about 79% of all mobile phone users can be found in developing countries [5]. People that never had access to a landline telephone or computers are now using mobile devices in the means of data transfer and communication.

Regarding the increasing number of people using mobile devices and the penetration of mobile phone networks, the mobile technology can also be used as an aid to improve the health systems in those areas, e.g., it allows providing specialized healthcare to people who live in remote areas in real time and reducing costs for transport and communication [6].

This paper shows the project and design of a multi-conference and multi-platform application for smart-phones as an m-health system, to improve the communication between healthcare providers and healthcare recipients, to eliminate the obstacles of distance, providing faster and specialized services to people living in remote areas.

II. TARGET PLATFORM

The application was developed to run on more than one platform of mobile operation systems available on the market.

According to the Gartner Incorporation, an advisory and information technology research company, Android, Symbian, Apple iOS and Research in Motion’s Black Berry are the top-selling smart-phone operating systems as can be seen in Tab. 1.

Aiming the development of a cross-platform application that achieves a greater availability to users, the system must support these different systems. Therefore, the system was designed using Adobe AIR runtime, a runtime that is present on Android, BlackBerry Tablet OS, and Apple iOS.

2012 IEEE 14th International Conference on e-Health Networking, Applications and Services (Healthcom)

978-1-4577-2040-6/12/$26.00 ©2012 IEEE 490

TABLE I. WORLDWIDE SMARTPHONE SALES TO END USERS BY OPERATING SYSTEM IN 4Q11

Operating System 4Q11 Thousand of Units

4Q11 Market

Share (%)

4Q10 Thousand of Units

4Q10 Market

Share (%) Android 75,906.1 50.9 30,801.2 30.5 iOS 35,456.0 23.8 16,011.1 15.8 Symbian 17,458.4 11.7 32,642.1 32.3 Research in Motion 13,184.5 8.8 14,762.0 14.6 Bada 3,111.3 2.1 2,026.8 2.0 Microsoft 2,759.0 1.9 3,419.3 3.4 Others 1,166.5 0.8 1,487.9 1.5

Total 149,041.8 100.0 101,150.3 100.0 Source: Gartner (February, 2012)

III. SYSTEM DESIGN

The application is separated into its environments, which are the “Login Environment”, the “Chat Environment”, the “Videoconference Environment”, the “Drawing Environment”, the “File Transfer Environment”, and the “Setup Environment”, each of which is subdivided again into their functions or components. Fig. 1 shows the Tree of Functions of the designed application.

Figure 1. Tree of Functions of the application

A. The Login Environment

The Login Environment is used in order to access the application. The low level diagram of the Login Environment is shown in Fig. 2.

Figure 2. Low Level Diagram of the Login Enviroment

B. The Register Environment

The Register Environment allows the client to creat an account to use the application in their first login. The Low Level Diagram of the Register Environment is illustrated in Fig. 3.

Figure 3. Low Level Diagram of the Register Enviroment

C. The Chat Environment

The Chat Environment creates an environment where helthcare recipients and providers can interact. Fig 4. shows the details of this environment.

Figure 4. Low Level Diagram of the Chat Enviroment

D. The Videoconference Environment

The Videoconference Environment creates a quick contact with another user, which can be helpful especially during emergencies. In this part of the application, the user is able to communicate with other contacts using a webcam. By default this environment display the user camera and 3 distinct member’s camera, but the user can switch which member will be displayed. The Fig 5. shows the details of this environment.

Figure 5. Low Level Diagram of the Videoconference Enviroment

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E. The Drawing Environment

The Drawing Environment offers a variety of tools as an aid in the communication using visual media. In this particular environment the user can take a picture and highlight parts of it, providing detailed attention to the diagnostic accuracy.

F. The File Environment

The File Environment allows the user to see the progress of a file being uploaded or downloaded and interrupt the process if necessary. Furthermore, the user can manage the lists of files that have been saved in the database, being able to delete or forward the files.

G. The Setup Environment

The Setup Environment allows the user to check the server status and set some basic configuration like change the username, connect to or disconnect from the server, turn the camera on or off and control the application's sound level.

IV. APPLICATION DEVELOPMENT

A mobile application is made up of screens, or views and they have two types of application to manage these views, the “view navigator application” and the “tabbed view navigator application”.

The view navigator application is application class that generates a framework with one control action bar and a content area where views are displayed and changed by functions in the application. The tabbed view navigator defines a multi-section framework creating both, an action bar and a content area as well as a tab bar that support navigation among the sections and select different views to be displayed in content area.

When the application starts, a splash screen image is shown and sets the application as a tabbed view navigator type, generating a content area where the Login View will be displayed and a tab bar allowing the user to access the Register Environment as shown in Fig. 6.

Figure 6. Login Environment (left) and the Register Environment (right).

When the “login” button is pressed in any of those two environments, the first tabbed view navigator is destroyed and another one is created generating the architecture visible in Fig. 7, reaching the desired architecture defined in the high level diagram of the project design

Figure 7. Architecture of the application, showing the transistion between the first tabbed view navigator application and the new tabbed view navigator

application.

This last tabbed view navigator is created with a horizontal scrollable tabbed bar (Fig. 8) that allows horizontal scrolling to reveal buttons off-screen, enabling to use as many environments as needed without truncate the button in the tab bar, i.e., it leaves open the possibility to add more environments in the future.

Figure 8. Horizontal scrollable tabbed bar.

Since different smart-phones have different resolution and screen sizes, to fix the problem of screen density, dynamic layouts was used to solve this [7]. In that way, all the components sizes were fixed with percentage sizing.

When the Chat Environment view is active, the application executes a function to connect to the Red 5 Server. If connected, the application starts to get data from the user’s microphone and camera to publish at Red 5 server. Once the user is connected, other members are allowed to see and listen to them.

The user, when enters in the Chat Environment, the application creates a shared object, that will display the messages sent by all the members in the room. Every moment when an asynchrony happens between the application and the server, the wall of messages and the users-list, with the members logged into the chat room, will be updated. If the user logs out the application, the connection with the server will close, stopping the data acquisition from the microphone and the camera. Fig. 9 shows the flowchart of the developed application.

If the user moves to the Videoconference Environment, their camera will be displayed and another three data stream connection will be created to the server by default in order to get the video data of the selected members.

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Figure 9. Application Flowchart

V. CURRENT IMPLEMENTATION

Currently, the implementations of the first four environments are completed and fully functional to perform the text, audio and video communication between two individuals. However during simulation it was found problems with the incoming audio at videoconference environment (Fig. 10). When a third person is included in the conference; it was not possible to set the incoming audio from both individuals to the datastream. The continuation of the application will require time division multiplexing to solve this issue.

VI. CONCLUSION

After running several tests using this application, it could be seen that the application is functional and can be a huge aid in improving the ways of communication between healthcare providers and healthcare recipients.

The design and working structure of this application are proving to be easy to use, allowing fast and easy access to the desired information.

The application was designed in order to facilitate the inclusion of other environments, adding functionalities specific to meet each m-Health specialization area.

Furthermore, the layout of the environments can be improved, allowing different layouts for different states, e.g. one layout when the device is held vertically and another when it is held horizontally. Also, adjustments can be made depending on the user category, e.g., if a doctor is using the application, there is a high probability that he will need more options in order to fine tune the settings according to his needs. The needs of each group can be found performing survey. In this way, it can be assured that the objective of developing a

multi-conference and multi-platform application for smart-phones as an m-health system can be met satisfactorily.

Figure 10. Videoconference Environment during test on FlashBuilder.

In conclusion, the main idea of this application is heading into the right direction of being an m-health system that supports the work of healthcare where it is needed. Once the above mentioned improvements and corrections have been made and the other environments have been developed, there is a high probability that this application will meet a great demand in the field of m-health.

ACKNOWLEDGMENT

The author thanks the IFSC for the scholarship of RBR and to Deustotech-LIFE for the opportunity of participating of this project.

REFERENCES [1] Global observatory for ehealth, Telemedicine: Opportunities and

developments in Member States: Report on the second global survey on eHealth 2009. Geneva, Switzerland: World Health Organization Press; 2010. World Health Organization, pp.6.

[2] Vital Wave Consulting, mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World. Washington, D.C. and Berkshire, UK: UN Foundation-Vodafone Foundation Partnership, 2009, pp.8.

[3] R. S. H. Istepanian, and C. S. Pattichis, “M-health: Emerging mobile health systems”, Springer Verlag, 2006.

[4] ITU, “The World in 2010: ICT Facts and Figures”, International Telecommunication Union, 2010.

[5] ITU, “The World in 2011: ICT Facts and Figures”, International Telecommunication Union, 2011.

[6] M. Whitehead, G. Dahlgren, and T. Evans, “Equity and health sector reforms: can low-income countries escape the medical poverty trap?”, Lancet, vol. 358, pp. 833-836, 2001.

[7] P. Bellavista, A. Corradi, R. Montanari, and C. Stefanelli, “Dynamic binding in mobile applications”, IEEE Internet Computing, vol. 7, n. 2, pp. 34-42, 2003.

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