A conceptual IoT-based early-warning architecture for remote monitoring of COVID-19 patients in wards and at home

Abstract

Due to the COVID-19 pandemic, health services around the globe are struggling. An effective system for monitoring patients can improve healthcare delivery by avoiding in-person contacts, enabling early-detection of severe cases, and remotely assessing patients’ status. Internet of Things (IoT) technologies have been used for monitoring patients’ health with wireless wearable sensors in different scenarios and medical conditions, such as noncommunicable and infectious diseases. Combining IoT-related technologies with early-warning scores (EWS) commonly utilized in infirmaries has the potential to enhance health services delivery significantly. Specifically, the NEWS-2 has been showing remarkable results in detecting the health deterioration of COVID-19 patients. Although the literature presents several approaches for remote monitoring, none of these studies proposes a customized, complete, and integrated architecture that uses an effective early-detection mechanism for COVID-19 and that is flexible enough to be used in hospital wards and at home. Therefore, this article's objective is to present a comprehensive IoT-based conceptual architecture that addresses the key requirements of scalability, interoperability, network dynamics, context discovery, reliability, and privacy in the context of remote health monitoring of COVID-19 patients in hospitals and at home. Since remote monitoring of patients at home (essential during a pandemic) can engender trust issues regarding secure and ethical data collection, a consent management module was incorporated into our architecture to provide transparency and ensure data privacy. Further, the article details mechanisms for supporting a configurable and adaptable scoring system embedded in wearable devices to increase usefulness and flexibility for health care professions working with EWS.

A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision‐making and referral processes

“…Although the positive findings on NEWS as a predictor of outcomes in this paper echo with much of the international literature on this subject (Paganelli et al, 2021;Paixão-Cortes et al, 2021;Stocker et al, 2021), the introduction of EWSs to care homes requires an understanding of the problems they can be used to address and what their adverse consequences might be. The clinical context of a care home is very different to that of an acute hospital ward, where EWS systems are usually employed.…”

“…Comas-Herrera et al ( 2020) have reported that, in a survey of 22 countries, 41% of deaths from COVID-19 occur in care homes. Systems based on NEWS2 scoring have been found to be an effective predictor of outcome in many countries including Italy (Paganelli et al, 2021), Brazil (Paixão-Cortes et al, 2021 and Norway (Myrstad et al, 2020) as well as in the UK (Stocker et al, 2021).…”

IoT-based COVID-19 Patient Vital Sign Monitoring

“…Paganelli et al [12] also proposed similar work. They used the data from the IoT and matched the result with the earlywarning score which has been commonly used in hospital, such as NEWS-2 [8].…”

IoT-Based Smart Health Monitoring System for COVID-19

“…The whole system is connected to android interface through API to track the recovery and health condition of recovered patient [21]. A similar framework proposed by Paganelli et al discussed various architecture utilization for monitoring of COVID-19 patients that could assist in detecting the COVID-19 [22]. The proposed architecture includes three layers mainly i.e.…”