A UPNP-BASED VIDEOCONFERENCE SYSTEM TO SUPPORT
HOME TELECARE SERVICES
Jaime Martín, Mario Ibañez, Natividad Martínez Madrid
Dep. Ingeniería Telemática, Universidad Carlos III de Madrid, Leganés, Madrid, Spain
Ralf Seepold
Hochschule Konstanz (HTWG), University of Applied Sciences, Konstanz, Germany
Keywords: UPnP, Video, Home healthcare, Telecare, Elderly people, HL7, OSGi.
Abstract: This paper presents a home healthcare system that implements videoconference calls based on the UPnP
standard to support telecare services. Firstly, it reviews the state of the art of telecare and applied
technologies. Our approach describes a system architecture that provides capabilities to integrate different
telecare services in a residential gateway. It addresses the challenge of the integration of patient relatives
and friends in the telecare service to enhance the user’s confidence. We propose a videoconference system
to communicate healthcare actors (patient, nurse, doctor and relatives) based on a widespread standard that
enables an automatic discovery of multimedia services and presents a seamless streaming negotiation.
1 INTRODUCTION
The progressive ageing population, the need of
controlling the healthcare costs and the expansion of
Internet broadband are increasing the interest to
develop telecare and telemedicine. Telecare utilises
information and communication technologies to
transfer medical information for the diagnosis and
therapy of patients in their place of domicile while
telemedicine is related with the delivery of clinical
care at distance (Norris, 2002). In some type of
patients with reduced mobility, like elderly or
handicapped people, telecare makes better medical
attention possible.
To reduce the difficulties currently suffered by
these people when obtaining the telecare services, it
is required to the healthcare actors maintain a
reliable relationship and the ICT (Information and
Communications Technologies) equipment complies
a widespread standard. Due to the need of friendship
and affection while their social isolation, is
important to involve the relatives and friends in
telecare service.
However, the current telecare systems often
ignore these social issues and also sometimes lack
adequate interoperability.
The telecom companies have begun to deploy
Residential Gateways (RGW) in the last years to
provide different remotely managed services. RGW
is a small computer with a software platform to
manage many services at home, like video-on-
demand, telealarm, etc. The OSGi specification
(OSGi Alliance, 2009) provides an architecture for
remote control of a platform and provides an
execution environment for services.
Our approach presents a model of video-
conference system to support telecare services in a
RGW running under OSGi. The audio/video calls
functionality, included in multimedia services
supported by the RGW, is based on the UPnP AV
(Universal Plug & Play for Audio-Video) standard
because provides a flexible and modular framework
to provide multimedia communications under a
well-known standard. The health data transmission
is based on the HL7 standard to allow the
communication with the mayor possible number of
external informatics health systems.
In Section 2, the state of the art of telecare is
reviewed. Our proposal is presented in Section 3,
describing the platform architecture and the
multimedia subsystem design. The last section
closes the paper with future work and conclusions.
398
Martín J., Ibañez M., Martínez Madrid N. and Seepold R. (2010).
A UPNP-BASED VIDEOCONFERENCE SYSTEM TO SUPPORT HOME TELECARE SERVICES.
In Proceedings of the Third International Conference on Health Informatics, pages 398-401
DOI: 10.5220/0002696003980401
Copyright
c
 SciTePress

2 STATE OF THE ART
Current state of the art of telecare/telemedicine and
the technologies involved are detailed next briefly.
2.1 Related Research on Telecare and
Telemedicine
Some telemedicine and telecare approaches based on
OSGi can be founded in the literature (Clemensen,
2004; Chen, 2005; Wang, 2006) but not integrate a
video-conference service in the software platform.
The Seguitel system (Plaza et al., 2009), is a
social and healthcare service platform for telecare
developed by Telefónica I+D based on OSGi and its
own middleware. It’s oriented to provide services
designed under a methodology that ensure an SLA
(Service Level Agreement) but this approach add
more middleware layers besides doesn’t deal with
the healthcare standard interoperability.
2.2 Applied Technologies
A brief overview of the applied technologies and
standards in our approach are detailed next.
2.2.1 OSGi Framework
OSGi framework is a Java-based open, common
architecture for network delivery of managed
services specified by the OSGi Alliance. The
services are added through software components
called bundles.
The platform carries out a complete management
of bundles life cycle: install, remove, start, stop and
update. The bundles are Java applications running
on the same JVM (Java Virtual Machine) that can
share code.
2.2.2 UPnP AV Standard
Videoconference system allows the communication
between the patient and the assistant or medical
people as well as his relatives during the telecare
service use. The videoconference functionality needs
a multimedia device infrastructure managed by the
RGW. The UPnP (UPnP Forum, 2009) is an
initiative of Microsoft and is developed by UPnP
Forum. The main target of this protocol is providing
a seamless connectivity between a vast variety of
devices and computers over virtually any type of IP
connection.
The UPnP AV is a standardized UPnP architec-
ture for multimedia systems that presents the next
advantages:
• It is a widely spread standard to develop
multimedia home networks.
• It allows an automatic discovery of
multimedia services.
• There are open source libraries of the
standard available.
• Low CPU usage for the streaming negotiation
& management.
Other approaches are based on SIP and IMS
(Haber & Gerdes, 2007) but it seems a complex
solution and too heavy for low cost devices.
3 VIDEOCONFERENCE SYSTEM
BASED ON UPnP TO SUPPORT
TELECARE SERVICES
Firstly, we present the telecare service platform.
Then we detail the design and implementation of the
UPnP-based videoconference system.
3.1 Overview
Telecare means to integrate patient-oriented
services, like telecommunication, health data
transmission and home automation. Our proposal
tries to provide an interoperable and scalable
solution. The system is divided in three basic
subsystems: home automation, telemedicine and
multimedia subsystem. These elements are managed
by a RGW running with Linux and OSGi framework
that make possible to host the different services
which can be managed remotely by the telecare or
access provider.
The multimedia devices used in the home telecare
service consist of a television or LCD monitor
connected to the RGW, with a webcam with
incorporated microphone. The patient is seated in
front of the monitor during the telecare session near
of the health measuring instruments.
An architecture schema for the e-health platform
is shown in Figure 1, where the multimedia
subsystem is colour in grey.
The task of eManager bundle is to manage the
different profiles of the several devices and the
personal recorded data. It offers a service to the rest
of bundles to get health data while keeping a secure
and logical access.
The telemedicine subsystem is formed by the
software, protocols and home health measuring
instruments, for example a personal scale or a blood-
pressure monitor. After the patient takes blood
A UPNP-BASED VIDEOCONFERENCE SYSTEM TO SUPPORT HOME TELECARE SERVICES
399

pressure reading or weighs, the devices connect to
the RGW by Bluetooth and send it the measure to be
saved in a local SQL database.
Figure 1: Architecture schema for the home telecare
platform.
The patient data must be transmitted to the
medical center following a messaging standard. HL7
(Hammond, 1993) is a widely applied protocol to
exchange clinical data in the industry. Moreover,
there are open source tools available to process and
transmit HL7 messages (HAPI, 2009; Mirth Corp.,
2009). These messages are sent from the home to the
medical center by the RGW, received by a medical
information system and displayed to the doctor in
his computer.
3.2 Telecare Scenarios
Some scenarios proposed for the telecare service are:
1) An elderly man has a medical citation with
the doctor to review his heart health.
2) An elderly woman that lives alone received a
video call from an assistant or relative to take
care about her.
3) A nurse demonstrates how to inject insulin to
a newly diabetes diagnosed patient.
Previous telecare proposals are often organized
not taking into account the communication with the
relatives and friends of the patient. But according to
several studies, sometimes the elderly or dependent
people are reticent to use telecare services because
they do not personally know the operator or contact
person in the telecare service centre. So we can
improve the usability of the service if firstly the
patient contacts to his familiar. In the first scenario,
for example, the doctor initiates a video call with the
patient to remotely check some readings about the
heart health, like the blood-pressure, heart rate or the
weight. The RGW keeps an address list of relatives
and friends and the patient can communicate with
them if he doesn’t feel well or call to emergency
service in a serious situation.
3.3 Multimedia Subsystem for e-Health
Platform
There are several UPnP frameworks available as
open source software. Cybergarage (Satoshi, K.,
2009) has been chosen because of its Java libraries
and compatibility. This framework provides basic
UPnP functionalities for service discover, eventing,
controlling and presenting.
Our approach is based in well known multimedia
and network standards: UPnP, HTTP (HyperText
Transfer Protocol), MPEG-2 and SIP (Session
Initiation Protocol). This protocol makes connect
remote devices possible in dynamic environments
like home access networks because the IP address
usually is received dynamically and the link status
would be variable.
The AV conference subsystem is design as a
symmetric architecture, so the RGW and e-Health
provider server will be running the same modules.
Audio and video content are transmitted in MPEG-2
format for both parts in a HTTP session after the
negotiation. A brief summary of the subsystem
modules is presented next:
• UPnP Media Server: it implements a Media
Server with UPnP capabilities, to register and
server previously recorded AV content or
real-time streaming offered by a video
camera like a webcam, for example.
• UPnP Media Renderer: it implements a
Media Render with UPnP capabilities. It
deals with receiving the audiovisual
streaming and provides the URL to connect
the AV stream.
• AV Control Point: it implements an AV
UPnP client. This module acts as control
point between multimedia devices that deal
with the transfer of audiovisual streaming or
content. Its tasks are mainly to register UPnP
servers and renderers, to configure outgoing
audiovisual streaming between e-Health
provider Media Server and patient RGW
Media Renderer or to configure incoming
audiovisual streaming.
• AV Manager: this module is a front-ed for the
AV Conference subsystem that permits to
offer an external high level API to set video
calls and one-way AV streaming.
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4 EXPERIMENTS
First experiments are being implemented in a
laboratory with two local networks simulating the
communication between two environments, like the
patient home and the assistant office.
The simulated RGW is running in a low resources
computer with an Intel Pentium Celeron CPU, 512
MB memory and Debian Linux. Apache Felix, a
OSGi R4 Service Platform compliant implemen-
tation released under an open source license is
chosen as the RGW software platform running over
a Sun JVM. The AV UPnP software is implemented
by a branched version of Cybergarage Java libraries.
A simple USB webcam with incorporated micro-
phone is used to acquire multimedia data.
5 CONCLUSIONS AND FUTURE
WORK
A new videoconference system to support telecare
services has been presented. Our approach tries to
integrate the health data transmission service with
the audio/video calls besides advancing in the health
data interoperability and the challenge of making up
different healthcare actors in the telecare to improve
the patient acceptation. Furthermore, the proposal
looks for a video-conference system that presents a
low CPU usage for the streaming negotiation and is
based in well-known standard.
The first results showed that it is possible to
implement a videoconference system overcoming
the network configuration issues and running in a
low cost device if no transcoding is required. This
will allow an easy integration in our telecare system
to achieve the goal of communicate patient with
healthcare professionals and relatives for telecare
services.
Some of the proposed future works are taking
some measures of the AV system like delay and
bandwidth; to complete system with other medical
equipment and on-line/off-line checks to obtain a
complete telemedicine system, testing the user
usability and to make an acceptation study with real
users in collaboration with health centers.
ACKNOWLEDGEMENTS
This work has been partly funded by the Ministry of
Industry, Tourism and Trade under the projects
Caring Cars FIT-330215-2007-1 (TSI-020400-2008-
37), OSAMI Commons ITEA 2 IP07019 (TSI-
020400-2008-114), Raudos (TSI-020302-2008-115)
and InCare (TSI2006-13390-C02-01).
REFERENCES
Norris, A.C., 2002. Essentials of telemedicine and
telecare. John Wiley and Sons.
OSGi Alliance, 2009. OSGi - The Dynamic Module
System for Java. Available: http://www.osgi.org
UPnP Forum, 2009. Universal Plug and Play standard.
Available: http://www.upnp.org
Plaza, P., Sanz, N. & Gonzalez, J., 2009. An Optimized
eHealth Platfom to Provide Electronic Services over
Dynamic Networking Environments. In Third
International Conference on Digital Society (ICDS
'09), pp. 1-6.
Clemensen, J., Larsen, S.B. & Bardram, J.E., 2004.
Developing Pervasive e-Health for Moving Experts
from Hospital to Home. In Proceedings of the IADIS
e-Society Conference. Avilla, Spain, pp. 441–448.
Chen, Y. & Huang, C., 2005. A Service-Oriented Agent
Architecture to Support Telecardiology Services on
Demand. Journal of Medical and Biological
Engineering, 25(2).
Wang, F. et al., 2006. Services and Policies for Care At
Home. In Pervasive Health Conference and
Workshops, 2006. pp. 1-10.
Hammond, W.E., 1993. Health Level 7: A protocol for the
interchange of healthcare data. In Progress in
Standardization in Health Care Informatics, G. J. E.
D. Moor, C. McDonald, & J. N. V. Goor, eds.
Amsterdam: IOS Press.
HAPI: HL7 application programming interface, 2009.
Available: http://hl7api.sourceforge.net.
Mirth Corp., 2009. Mirth Connect. Available:
http://www.mirthcorp.com/products/mirth-connect.
Haber, A. & Gerdes, M., 2007. Remote Service Usage
Through Sip with Multimedia Access as a Use Case.
In IEEE 18th International Symposium on Personal,
Indoor and Mobile Radio Communications (PIMRC
2007). pp. 1-5.
Satoshi, K., 2009. Cybergarage UPnP framework.
Available: http://www.cybergarage.com
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