普及式社區照護服務網路之設計與分析

Design and Analysis of Pervasive Community-Care Service Networks

賴建志(Chien-Chih Lai)

指導教授 ： 李仁貴

國立臺北科技大學/電資學院/電腦與通訊研究所/博士(2008年)

https://doi.org/10.6841/NTUT.2008.00109

摘要

當人們逐漸老化，對於健康評估與醫療照護服務的依賴性亦會加重。然而，目前台灣地區現行的健康照護架構是不太能夠滿足逐年增加之高齡化人口的需求。為了讓老年人能在他們自己家中及居家附近的公共空間(或通稱為他們所居住的社區)裡，可以長時間獨自且安全地生活，在地老化是一個可行的解決方案。普及式健康監測是一個可以幫助人們在地老化的技術，其主要是透過無線方式，持續或定期地監測老年人的生理資料，並提供給健康照護人員分析與紀錄。
為了提供個人化的健康照護服務，本論文提出了一個普及式社區照護服務網路架構，其主要是由一個行動化居家生理監測網路及一個無線的公共區域生理監測網路所組成。整體網路架構是以無線行動通訊網路技術為基礎，並以有線寬頻網路做為傳輸骨幹，以期能提供老年人或慢性病患者一種普及且無所不在的健康照護服務。
對於居家生理監測應用而言，為了能有效預防與控制老年人的身體狀況或是當突發狀況發生時可以提供緊急救援服務，長時間地監測其生理參數(如心電訊號或血壓等)是非常重要的。有鑑於此，本文發展一個以多跳代傳通訊技術為基礎之行動化居家生理監測網路，透過此網路，可以在家中隨時隨地去監測使用者的生理資料，不會受到空間上的限制且亦不用擔心室內通訊死角問題。且家用閘道器亦加入一緊急預警機制，即當閘道器檢視出使用者之生理訊號發生異常時，會利用簡訊方式通報照護人員，立刻進行照護或事件處理。另外，為了確保生理資料傳輸時之及時性，詳細的網路延遲分析亦會在本文中探討。
然而老年人也可能會常常去家裡附近的公共空間活動，為了能進一步去提供生理訊號監測服務，本文提出一個以有線存取節點所架構而成的公共區域生理監測網路，其主要是整合無線區域網路與有線電視網路，以提供一種可於室外應用的普及式照護服務。有線存取節點是由一組纜線數據機與一組無線區域網路存取節點所組合而成，然後再整合到目前戶外的有線電視幹線放大器外殼中，其主要目的是為了能有效延長戶外的無線存取範圍，以期能輔助建構一個無所不在的健康照護服務網路環境，提供更有效率的資料存取服務。
最後，本文亦實作所提出之普及式社區照護服務網路，即一針對室內應用的行動化居家生理監測網路以及一應用於戶外之無線公共區域生理監測網路。整體的實作測試結果也進一步驗證所提出之健康照護監測網路的功能及其可行性。

關鍵字

普及健康照護 ； 居家照護 ； 社區照護 ； 健康照護資訊學 ； 生理監測 ； 無線 ； 多跳代傳網路 ； 有線存取節點

並列摘要

As people grow older, they depend more heavily upon external support for health assessment and medical care services. The current healthcare infrastructure in Taiwan area is widely considered to be inadequate to satisfy the needs of an increasingly aging population. Aging in place is one solution to ensure that the elderly can live safely and independently at their houses and in public places near their residences (generally called as living community) for as long as possible. Pervasive health monitoring is a technological approach which helps people age in place by wireless monitoring and by lastingly or regularly providing key physiological information to healthcare providers.
In this dissertation, a pervasive community-care service networking infrastructure, consisting of a home-based and a public place-based wireless physiological monitoring network, is proposed for personal health monitoring. The whole network infrastructure is mainly based on wireless mobile communication network technologies and over the existing wired broadband network as the transmission backbone. It is aimed to provide pervasive healthcare services to the elderly and the chronic patients who live at home.
For home physiological monitoring, it is necessary to continuously monitor the elder's physiological parameters, such as electrocardiogram (ECG) and blood pressure (BP), to effectively prevent and control the health condition or even to provide urgent treatment or care while an emergency, such as the abnormal variation of heart rate (HR), occurs. To this end, a wireless in-home physiological monitoring network, based on multi-hop relay communications, which can ubiquitously and lastingly monitor the elder's physiological data at any time or any place at home without space limit and the dead spot, is presented and designed. For emergency response handling, furthermore, an emergency alert service mechanism using short message service (SMS) is also added to the home gateway for emergency care and rescue services. Moreover, in order to assure the timeliness of transmitting the physiological data, the network latency analysis in data forwarding stage is also investigated in detail.
However the elderly may go away from their homes to frequently visited public places nearby. In order to further support pervasive and long-term care services, a cable access point (CAP) based public health monitoring network, composed of wireless local area network (WLAN) and cable television (CATV) network, is presented and developed for monitoring physiological data. The key CAP device is consisted of a cable modem (CM) and a WLAN access point (AP) to be integrated inside the chassis of an existing outdoor CATV trunk amplifier for outdoor deployment. The main purpose of the CAP device is to effectively extend the coverage of outdoor wireless access link and to further provide a data access-efficient service for constructing a ubiquitous healthcare service networking environment, especially in communities or in metropolitan area.
The proposed pervasive community-care service network infrastructure including both the home-based and the public place-based healthcare monitoring networks has been implemented and tested for physiological monitoring. The experimental results successfully validate the functions and feasibility of the proposed network.

並列關鍵字

Pervasive healthcare ； Homecare ； Community-care ； Healthcare informatics ； Physiological monitoring ； Wireless ； Multi-hop relay network ； Cable access point (CAP)

參考文獻

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