Remote patient monitoring (RPM) entails the electronic monitoring of physiological measurements in a setting other than a hospital, such as a patient’s home, or a community setting such as a residential or nursing home.

RPM can lead to better clinical outcomes (Hopp2006); (Clarke2005) and be more convenient and cost-effective (Finkelstein2006); (Hersch2001) than traditional institutional care, since it enables patients to remain in their usual environment whilst being looked after professionally. However, not all reviews of cost-effectiveness have proven conclusive, which has been blamed on the poor design of projects (Whitten2002).

RPM remains to be integrated into mainstream healthcare (Barlow2006); (Yellowlees2005), despite its potential for improving health outcomes and effective use of resources, and the efforts of government, industry and academia. This can be seen in the relatively low utilisation and success rate of many projects and the lack of routine services.

A holistic view

The REACTION project has very clear objectives for overcoming the deployment obstacles inherent in previous programmes by taking a holistic view and pay proper consideration to all aspects of this complex issue.

REACTION will incorporate socio-economic aspects of diabetes monitoring and its deployability in large scale health systems; investigate cost effectiveness of proposed solutions as well as viable business models for the providers thus creating the foundation for a viable and sustainable industry

REACTION will demonstrate a stable yet technologically highly innovative platform by using the right blend of mainstream proven technologies (backend health information systems, wireless technologies), new innovative solutions based on proven research experience (PAN networking and interoperability) as well as state-of-the art technological solutions developed during the course of other projects (ePatch multi sensors, semantic web annotations, networked systems middleware)

REACTION will seek to influence important standardisation work in bodies such as ISO TC215 WG 7 (Medical devices), CEN TC251 WG IV (interoperability), IEEE PHD (personal health data) interfaces and security (WWRI) as well as Continua Health Alliance working groups on architectures through its active partners in these bodies

Privacy and trust

Privacy is one of the key enablers for various scenarios in the eHealth domain. Concerns regarding privacy legislation, standardisation and implementation emerge at the same time as the introduction of Electronic Health Records or the digital patient (http://www.ercim.org/) . Establishing trust in this area could enable various applications as healthcare in itself is a multidisciplinary scientific challenge.

Trust has different definitions in the context of applications for healthcare. Trust is related to privacy requirements and also the reliability of stored data. New technologies can provide hardware security anchors for a low price addressing different dimensions of trust.

REACTION will define “trust” and develop concepts and hardware anchors for trust to be used in application security models

Security implementation

With the increase of cross-boundary services that span over several organizations or web sites and involve multiple agents, the need for a distributed way to manage the user identity becomes an increasingly concerning issue. The right identity management solution should allow people to have control over their own data and enable users to keep one or more identities over time that stay fixed, regardless of what services are still in existence.

OpenID is a distributed identity management design that works with the existing web infrastructure. An OpenID-enabled site can ensure that for a given identity URL, only the person owning that URL can authenticate, and nobody else can fake that identity.

SAML, (Security Assertions Markup Language) may contribute to provide a solution for distributed identity management in an open environment. SAML is designed to deliver interoperability between compliant web access management and security protocols, so it should be easily integrated with the rest of the platform. It is NOT a security solution, though and does not address privacy policies.

REACTION aims to integrate OpenID with SAML. Using SAML will enable implementation of single-sign on and distributed transactions by making the client application retrieve its security assertions from a trusted authority and sending it to the other end of the transaction, or making the other end of the transaction look for the required assertions before the completion of the transaction