New Design and Performance of IoT cloud for Smart Healthcare and Monitor system

Cloud computing converges new technologies and existing ones to offer as services with all capabilities of a computing system to different kinds of users. These services can be accessed from anywhere with the help of an internet connection independent of their physical location. The Internet of Things (loT) is a platform that enables the capturing of real-time information, facilitates examination and analysis of this information and provides a connected environment by sharing it with various stakeholders. Cloud and loT are mutually dependent on each other. loT can benefit from the virtually unlimited capabilities and resources of Cloud to compensate for its technological constraints (e.g., storage, processing, and energy). Cloud can benefit from loT by extending its scope to deal with real things in the real world and for delivering a large number of new services in a distributed and dynamic manner. The new designs for healthcare and monitoring systems must possess the following characteristics.

  • 1. On-Demand Self Service: loT Cloud Computing is readily available to all when you need it. As Cloud Computing resources are a web-based service, it can be accessed without any help or permission from others. But the most primary need for establishing communication is by internet, because internet is everything in the world.
  • 2. Broad Network Access: loT Cloud Computing provides a lot of connectivity options. Cloud computing resources can be accessed via tablets, mobile devices and laptops with internet connection. This makes it easier for the user to easily access the devices that they mostly like. Without the help of loT, cloud computing can't be accessed and function; that's why networks are most significant nowadays.
  • 3. Resource Pooling: Resource Pooling means that it can be shared for those who know where resources address. Resource pooling will make people know the address that can be accessed anytime and anywhere as they want. It makes the user able to access what they want and when they have free time to access. In loT context, an IP address can be easily assigned to every "thing" on the planet they want like computing IP address accessing.
  • 4. Rapid Elasticity: In loT Cloud computing with Rapid Elasticity you get what you need, because of its rapid elasticity nature. This cloud computing provides the freedom to suit with what you need. You can easily and quickly edit your software features and add or remove user inside your cloud computing.
  • 5. Measured Service: loT Cloud Computing is a Measured Service in the meaning that you get what you pay for. This cloud computing will measure your usage about of their services such as storage, processing, bandwidth and active user accounts inside your cloud computing. The meter will increase as much as you utilize the resources. This system is known as Pay Per Use (PPU).

The healthcare industry is predominantly moving towards affordable, accessible and quality healthcare. All organizations are striving hard to build communication compatibility among the wide range of devices that have operated independently. loT and adopt loT driven systems and processes have the potential to model this kind of healthcare, which heavily relies on patient participation. This will subsequently improve the way health services are being delivered. loT is here to stay, and will continue to evolve fast, leading to impactful and positive changes for all stakeholders in the healthcare industry.

There's no doubt that the Internet of Things (loT) creates a new technological ecosystem in healthcare, helping organizations manage bottlenecks in care and bridging the gap between patients and providers. The list of applications for connected devices in hospitals keeps growing from real-time staff tracking across facilities to ensuring preventive equipment maintenance and 24/7 patient vitals monitoring in ER and resuscitation departments. But care delivery doesn't stop after discharge. A range of smart consumer-facing medical devices can ensure that the patient's health status will be kept under control between office visits. This will allow providers to grasp a multitude of subjective and objective symptoms, analyze them, build patterns and observe them in dynamics. Additionally, the patient becomes more informed and invested in their own health management, whether they have a chronic condition or not. With valuable insights about regular processes or sudden sensations, such as mood, sleep, temperature, pain, cough and more, patients gain a better understanding of how their own body works.

Experts acknowledge the growing role of loT in healthcare, too. For instance, Deloitte anticipates the healthcare loT market volume to reach $158.1 В by 2022. However, with changes come challenges. As many connected medical devices gather patient vitals in chronic and acute cases, assuring their performance becomes the vendors' top priority. Any performance interruptions bear potential risks for patient safety and health outcomes, with varying severity depending on a particular device's intended purpose. Therefore, Quality Assurance (QA) specialists are under increased pressure when carrying out performance and compatibility testing of medical loT devices. If the team is unaware of domain specifics and isn't ready to mitigate arising challenges, the resulting product may fall short of the high requirements for medical software or even fail FDA approval. The challenges in the loT clotd smart healthcare system are discussed as follows.

Disruptions in Internet

When checking the performance of medical loT software, testing specialists deal with the load, network bandwidth, latency, and other metrics both for mobile and web applications. While it is undesirable for a website to crash under an unexpected load surge, in healthcare loT crashes are unacceptable, especially not for smart medical devices directly involved in patient care, such as a continuous patient monitoring system or a smart insulin pump. Still, force majeures do happen, and it is critical to prepare the product accordingly. When testing consumer-facing loT devices, some QA teams need to take all the important variables into account. For example, use conditions can be highly diverse, especially when the connected device is designed for use in rural areas. From smart thermometers to blood coagulation meters and inhalers, the stability of the user's internet connection can twist the test results or even undermine them if the receiving specialists weren't aware of the actual network bandwidth. To try and compensate for such pitfalls, both developers and QA specialists have to ensure that service disruptions won't affect data transmission. For example, all sensitive PHI data can be backed up prior to transferring, so that each data package could be erased only after the sending attempt is successful. Additionally, performance engineers need to keep in mind that loT devices don't operate with planned downtimes, so any patches and updates have to be integrated seamlessly into the device operation. It's highly recommended to test the process at least with the first patch in order to polish it and ensure that new updates won't disrupt user experience or tamper with sensitive data.

Diversity of Protocols

As connected medical devices are entering the mainstream, they are creating a whole new niche in digital care deliver)'. With this comes another performance testing challenge: devices frequently need new protocols to manage communication with the servers. The healthcare loT ecosystem is already complex since it lacks standardization of loT protocols currently in use[128]. While the Message Queuing Telemetry Transport (MQTT) protocol is one of the most common because it handles low bandwidth networks and low-memory devices, there are also HyperText Transfer Protocol (HTTP), Constrained Application Protocol (CoAP), Extensible Messaging and Presence Protocol (XMPP), Data Distribution Service (DDS), and many others. The diversity of available protocols and the devices they support puts an additional strain on performance engineers as they have to find a fitting load test tool covering this particular combination. But that's not the only difficulty in choosing the right toolset.

No Special Testing Tools Were Made for Healthcare Applica tions

There's no better way for QA specialists to hop into a clinician's shoes than deciding on the testing toolkit for a particular connected device. They need to pick the right instruments to arrive at a relevant diagnosis as well as treatment suggestions. Healthcare loT architectures are complex and comprise unique combinations of devices, sensors, and actuators communicating with disparate systems via distinct protocols, generating and transferring enormous amounts of data. Not to forget that patient data is highly sensitive, so each transaction should be secure. To find a fitting load testing tool, performance engineers can break down the infrastructure in question and arrange the parameters according to their load testing priorities. For example, if both continuous data sharing and scaling to multiple devices are required, it's worth compromising only when there are thousands or millions of devices. Continuous data sharing, however, should be prioritized in any toolkit.

Difficulties in Performing Healthcare IoT Performance Testing

While testing the performance of a connected medical device might seem similar to that of a mobile app or a website, the complexity of loT architectures creates new challenges for QA teams. These challenges can overwhelm even experienced specialists because they have to evaluate the system while always keeping in mind patient safety and data integrity. Here are a few suggestions on how to effectively deal with the challenges described above:

  • • Emphasize atypical use cases: whether you are evaluating a bedside monitor or an implantable smart device, users can and will get creative with the system.
  • • Don't try to find a perfect load testing product supporting all protocols within your healthcare loT stack. Pick the tool with an SDK to start building tests right away.
  • • Narrow down your test scenarios by defining the most popular device/software version pairings to ensure more effective coverage. Then, test all new devices that communicate with the network and ensure that data will stay safe in case of internet network disruptions.

As mHealth [383] evolves, the growing adoption of machine-to-machine (M2M) technologies is helping bring greater automation to remote monitoring, as wireless technology is used to transfer real-time data about patient vital signs and conditions directly to medical staff. M2M technology can also help in the tracking of drugs and medical equipment and can enable better management of healthcare workflows. For patients, this means continued monitoring and treatment delivered in a way that is more convenient, less disruptive and that ultimately enables them to enjoy a better quality of life.

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