ENVS3400 Advanced Research Project

ENVS3400 Advanced Research Project

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ENVS3400 Advanced Research Project

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ENVS3400 Advanced Research Project

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Course Code: ENVS3400
University: The University Of Newcastle

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Country: Australia

This is followed by your conclusions including an explanation of how your research questions or hypotheses were formed and what areas you would propose for further study. The areas of further study are based on the ‘gaps’ that you have identified in the existing literature. The purpose is so you learn how to:Identify and formulate enquiry questions and or hypotheses that defines the gap you have identified; Search and locate literature; Analyze secondary data and information; Synthesize new information into the literature review;Establish context for your enquiries; and Write at an academic level appropriate for publication

This chapter helps in developing a deep understanding and knowledge regarding the significance of remote healthcare monitoring in the healthcare. The chapter highlights the concept of remote healthcare monitoring along with discussing the basic design of the MHM, opportunities, challenges and the impact of the patients and the healthcare professionals. The implementation of RHM has enhanced the healthcare system in Australia.
It is important to understand the ways the healthcare professionals can ensure in delivering invariable and eminence care to the patients staying in the remote locations. It is also significant in understanding the ways patients ensure they get the support of the professionals without spending much time along with efforts in visiting the hospital. The answer to all these questions lies in the fact of patient monitoring system; an action taken up in investigating the health of the patient without physically being present there, helpful especially for elderly people or the ones suffering from chronic disease. The incorporation of the technologies of communication mould into the patient care has offered the professionals with game shifting resolution in delivering a better quality of medical awareness on remote basis.
Remote monitoring is one of the healthcare sort technologies that facilitates the patients in using a mobile medical device in performing of a schedule test and sending the data to the professionals related to healthcare in real-time (Benharref &Serhani, 2014). Remote monitoring technology takes into consideration the regular monitoring devices like the meters of glucose for patients having diabetes, heart or blood anxiety monitors for the patients receiving care for cardiac treatment. This data can be send to the office of general practice with an internet connection along with an application for software installed in a computer, tablet or Smartphone in patient’s home. The information is being stored within a database so the professional of healthcare can evaluate the data.
Ways of curbing chronic conditions:
It is only subject to time before the exam-room-centered centers around the care for patients, giving way to the management of the patients dispensed in maintaining or improving of the health. However, it would not give away the routine and active treatment of the sick patients by the physicians. As per Klasnja & Pratt, (2012), new models of payment added with financial incentives and hindrance for the physicians, call on the providers of healthcare in better managing the population of patients as a mean of preventing issues related to health and progress on the outcome.
This business that is emerging and the need for clinical has pretended the expansion of a technology class that associates patients present status of medical to the physicians along with other caregivers in the hospitals and practices offering primary care. It is a compilation of the vital-sign takers, trackers for activity along with other devices in stepping on or strapping on and then transmitting the readings of the same to a assortment position within a computer or any secured site within the internet ‘cloud’. At its very best such technologies have the ability in picking the weight again, prominent hypertension or certain other apprehension before they develop into threats to life or health.
Remote monitoring is extremely significant and potentially in the vanguard for the technologies in mobile for its probable significance in lessening the rates of hospital readmission that sometimes becomes big headlines. Remote monitoring takes in keeping the patient in touch with the physicians over a longer period of time outside the surroundings of acute-care so that one does not have to wait for the disasters to take place in bringing the deteriorating condition to the attention of the provider.
Patients want admittance to these sorts of remote monitoring technologies in improving their health condition. A health patient survey conducted by the public relations agency Ruder Finn found out that approximately 34 per cent of the patients need their physicians in having more admittance to the remote monitoring technologies. Patients who are older require these sort of technologies even more with the survey stating around 40 per cent of the older ones requiring access to the technology that has the ability in alerting the physicians along with other caregivers if there is any sort of emergency in health.
Under the present circumstances, establishment of the remote monitoring system and being paid for the same vestiges a challenge, mainly for the independent practices of small and solo nature. Physicians have already been tackling with and are besieged with a multitude of technology systems that requires proper understanding and investing from the systems of electronic health records along with the portals of the patients to the platforms for telemedicine and social media.
Instituting of the remote monitoring, as stated by the experts would be requiring changes in the ways medical practice has been conducting its business, might need joining a clinically incorporated system of providers for scaling the process of monitoring in appropriate basis. Physicians are required in developing fresh ways for interacting with the patients along with instituting new procedures and tasks for the members of the staff in taking on this flood of data and making it practical and more useful for developing of the care for patients and diminishing the cost factor.
The monitoring of the vital signs of a person takes in an observer making use of their own senses in direct manner in determining the rate of pulse, breathing and many other factors. Further sophistication is being produced through the introduction of the simple form of technology; however the act of monitoring is being performed directly by the physician. All the remaining procedures, taking in the synthesizing of the proper response occur within the brain of the clinician. As per Desai, (2012), the technological advancement along with the concluding stage of remote monitoring has separated the numerous links within the chain between the factors of acting and measuring and making explicit the chain of events, actions along with the decisions associated with the patient and the clinician.
The several links within this chain might include the following factors: acquisition of the data using the proper sensor, diffusion of these data to the clinician from the patient along with synthesizing of a proper action. Adding to that would be the decision support mechanism and storage of the data.
Mainly depending on the setting, data transmission can be done by wired or even through wireless connections. Modalities take into account both the wired and the wireless networks of the computer, networks of telephones and that of the mobile phones. Systems that recognize the modalities available and use them consequently for the data transmission are being improved or developed (Istepanian, Laxminarayan & Pattichis, 2014). The transmission technology is stated to be the indispensable glue in the several possible topological chains. Its abilities predicate the effectiveness of some of the other components. Technological transmission will be required for selection as per the particular use envisioned. The process of data transmission from the patient party to the clinician might be a continuous process or might occur only when an exception of pre-defined nature has taken place or at the time of availability of connection.
Under the present circumstances, various systems tend to use the standards of proprietary for the process of data communication.  Governments have started setting up of the aside proportions of the spectrum of electromagnetic for the purpose of specific use of the wireless telemetry, though not always consistent across the international regions with cropping up of the issues related to interferences (Piyare, 2013).
Data Integration with state of patient:
This process may be conducted either with the help of a computer or a clinician, or it might be both. Incorporation of computer along with the data analysis process and their combination into the information on which the act is to take place can occur anywhere within the chain. Adding to that is the fact it might be distributed across the process. Amongst many other things, this is mainly dependent on the requirement of data that is being conveyed along the chain that is itself dependent on the availability of the bandwidth and its cost. Raw data needs to be transmitted or simple the rate of heart, a full set of the vital signs that could be conveyed likes the warning score or other point of index of the severity of the patients on the factor of illness (Suryadevara & Mukhopadhyay, 2012).
The uncovering of a meticulous patient state resulting from the incorporation of the computer along with the evaluation of the data and their synthesis might be used in triggering the transmission of the data. These are mainly the engineering decisions inter-related to certain particular application. Apart from just the physical service part of the system, this network also makes patients feel mentally comforted knowing that are always being monitored and if any problem arises, they will be given help as soon as possible.
The cost of delivering the healthcare is increasing with every passing day and managing of the same is becoming an issue, especially in Australia. Targeting of the healthcare services in assisting the ageing population along with the ones suffering from chronicle diseases accounted for over 70 per cent of the $103.8 billion expenditure related to Australian healthcare during the period of 2007-2008; can assist in reducing the load on the systems of health along with the hospitals. ‘Frequent Flyers’ are stated to be high cost patients within the system of health, who typically have an amalgamation of complicated medical conditions like the diseases of lungs, cardiovascular disease or like diabetes along with visiting the hospital twice or thrice per year.
Funded by the Australian Government Tele-health Pilots Program along with CSIRO, the formation of the e-health proficiency and partnered with the NGOs, local districts of health and industry partners in delivering of a national level tele-health of home monitoring of the chronic diseases for the aged people. A survey was conducted over a year in enabling the chronic disease patients in self-managing their conditions within their homes through the stipulation of the services related to tele-health (Ventola, 2014). Workers related to health could review changes in the conditions of the patients tenuously and offering of proper care interventions prior in helping them staying out of the hospital and developing their life quality.
It is a global challenge to ensure timely healthcare access, in both rural as well as urban areas. Every nation, every government tries to ensure the best possible healthcare facilities for its citizens. It harnesses every resource in its knowledge to bring the maximum healthcare benefits for the people (Hassanalieraghet al., 2015). Along with this, with the global advent of internet and access to information from any place at any time, monitoring the healthcare system constantly and using this technological tool is becoming increasingly important. This newly developing aspect of healthcare providing services is altering all the previously held ideas about the roles and responsibilities of each component and player of the service sector. Every input of the sector is having itstasks and responsibilities redefined. This is altering the whole equation and structure of the sector (Rahmaniet al., 2015). The continuous rise of the internet has rendered almost every information relating to healthcare and diseases to be free and accessible by everyone. This means that everyone can gather information by themselves without having to be reliant upon the health care providers.
The RHM is a systematic framework that enables health care providers to monitor and treat a patient outside of the conventional settings of a clinic. However, this facility of being accessible to the health care services at all the time may increase the costs of the same. But the fact is, incurring the extra cost may ultimately make sure that a patient has a longer and healthier life. Patients are given health services which is delivered to their own homes, which means that the elderly people do not have to be reliant on anyone to avail the services(Islamet al., 2015). In today’s world, where everything has to be on time and every task has to be perfectly executed as soon as possible, most people do not have the time for check-ups to the doctor or visit clinics regularly(Rahmaniet al., 2015). Remote Health Monitoring aids in this aspect tremendously. Many rural areas, where transportation and regular communication is a problem, can be benefited by the system as it alerts the health care professionals about any problem that arises.
There are numerous benefits to including internet use in the RHM system. The most important aspect of this incorporation is the fact that this increases efficiency. Satellite based system and a tele health computing system can notify the physicians and other health care professionals if any fluctuation in the health condition of any patient is noticed (Baig&Gholamhosseini, 2013). This enables the health care personnel to act promptly and deliver the health services without much hassle. Any kind of monitoring software or app can be installed on the patient’s computer, mobile phone or tablet, that would keep track of the patient’s health conditions and send notifications if need be. Even if the patient is not suffering from any sudden or critical problem at any given point of time, the software sends data to the health care providers on a regular basis which allows the health consultant of the patient to make out a trend from the collected data. For patients who are chronically ill and cannot travel long distances, being monitored remotely decreases the number of clinic visits and this is a very important advantage of the system.
One of the most popular remote monitoring systems worldwide are the wearable sensors that have gained increased demand over the recent years. Many of these devices are commercially available in the open market today. These devices have significantly helped in the betterment of personal health care and fitness level of patients and these devices are being increasingly incorporated into the remote health monitoring system (Benharref&Serhani, 2014). In the near future it is quite possible to be in a health care system which would see patients being closely monitored for periods of time any indication of a deterioration in the health of the patient can be predicted based on a trend that would result from the collected data that was sent from the remote monitoring devices. Such an integrated system would drastically reduce health care costs and greatly improve the overall health condition of the society.
The most popularly agreed upon framework for remote health monitoring system has a three level format which encompasses all aspects of health care service providing, both physical health monitoring as well as keeping an eye on the psychological dimensions of the patients as well. This part of monitoring the psychological side of the patient helps the doctors to have comprehensive data about the overall condition of the patient and allows the doctors to treat the patient in ways using practices that also ensures mental well-being of an individual as well as the person’s emotional needs (Chenet al., 2014). The construction of the currently proposed framework comprises of a Wireless Body Area Network (WBAN), which consists of the wearable sensors, that act as the units and instruments that help to collect data about the physical and mental condition of a patient, a network of communication where the patient is monitored continuously and finally a service side of the entire field. Many frameworks propose an integrated and inclusive monitoring system where the wearable units would be looking into the parameters that indicate emotional fluctuations of an individual, like blood pressure and body temperature.
The current framework would be seeing the wearable units gathering data and transmit the same onto a server, which again turns the data into an observed form and creates a numerically measurable data table(Hassanalieraghet al., 2015). The server then stores it on a remote server which can later be retrieved by clinical staff and other health care professionals to study the trends of a patient. Content service application enables the staff to access the data that is stored on the cloud base system. Patients who have a high risk of heart diseases are benefited through specific medical applications like WANDA, which is an end-to-end remote health monitoring system which also facilitates in analysing the data.
It is not enough to only have the technology to gather data of the patients. To treat a patient completely and in an all-inclusive way, the technology that is to be adopted has to be able to facilitate in the data analysis and vizualisation process. These are integral components of the remote health monitoring system. Being able to accurately diagnose the conditions of a patient is of utmost importance if one is to be treated right (Dinhet al., 2013). A good diagnose would also have data of the patient’s psychological characteristics that are collected over a long period of time, along with the patient’s physical conditions. Since these data can be vast and containing many minute details, it may be hard and incredibly time consuming if it is to be done manually. The algorithms that are used as the set of guidelines take all of these data sets and then produce them as graphs or pie diagrams, so that the medical professionals can easily understand the condition of the patients at a glance.
The incorporation of internet in the health care system have radically changed the amount of work that the staff has to execute (Vashist Schneider & Luong, 2014). The artificial intelligence that has been introduced into this system has helped the system to be more flexible and a more unique and customised form of medical attention can be provided to each individual based on their personal needs and requirements.
Data collection: This stage is executed by remote health sensors and wearable sensors and units, which take note of different types of parameters that are inputs and indicators of a person’s psychological being. ECG, respiration rate, temperature, EMG are all recorded by these monitoring units (Piyare, 2013). The sensors are connected to a server and a network through an intermediating device, most normally the patient’s smartphones.
The units, because they have to be on the body of the patients, must be light, small and should not pose as an obstacle for the patient’s movements (Jara, Zamora-Izquierdo&Skarmeta, 2013). The devices have to be energy efficient as they would be running on batteries and it is impossible to change the batteries on a regular basis. This low energy use may become a problem and a sophisticated design has to be made to ensure the data to be transmitted for a long period of time. The more contemporary devices can be worn on different body parts and these give better estimation and records of the data of a patient’s psychological parameters as they are attached to the body.
Data transmission: This part of the entire system relays the collected data of the monitoring units to the servers and makes it possible for the clinic staff to access the data from anywhere. The units relay the data to the servers in real-time, which means, any sudden fluctuation can be noticed and immediate actions can be taken. The data is uploaded to the server of the Healthcare Organization (HCO), and absolute confidentiality is maintained (Stankovic, 2014). Aggregated data is relayed to the server of the HCO where it is stored for a long period of time to enable the health care professionals to monitor any trends of the patient’s health. This part of the entire data collection and analysing process forms the IoT based architecture as this makes sure the data can be accessed at any point of time and from anywhere using a concentrator.
Cloud processing: This stage again has three crucial parts to it. Storing the data, analysing and visualisation. This part not only stores the data of the patients for a long period of time but also acts as a helping tool for the health care professionals to diagnose the medical conditions of the patients (Islamet al., 2015). The analytical component merge online health records and the data collected from the sensory units and this is fast becoming one of the best ways to treat some of the diseases that require extensive and intensive care. Visualisation helps in the task of going through volumes of data and makes it easier for the physicians and other professionals to easily comprehend the condition of the patient.
The wearable sensory units provide psychological measurements and can collect or provide data which are much more accurate in nature and temporal sampling over longitudinal time scale data can be gathered. This rich set of data can help the medical staff immensely when analysing the conditions, both psychological and physical, a critical patient. Different types of algorithms that are employed can benefit in correlating the observations of the sensors and clinical diagnosis (Hossain & Muhammad, 2016). These processes can be used for a longer period of time to greatly improve the medical care that is provided to the patients and who need constant care. Diagnostics, that form the basis of any treatment and must be done accurately to understand the condition of a patient can be done in a much better way (Ventola, 2014).
However, some challenges are there which need to be eliminated if the analysing process is to be done on a full scale basis. Even though the online medical records are plentiful, they are very poorly organised and not tagged or stored under categories, which makes it a problem while trying to get a general overview of a common type of disease. It makes it a lot of work to go through a lot of data to find any similarities between two different diagnoses (Pageet al., 2016). The heterogeneity of the collected data is not specific to the demography of the data, which makes it difficult to conclude any specific region reflects any specific type of health problems.
This section of the paper pondered over the prospects of Remote Health Monitoring system being done by using internet and how can artificial technology and how can the data that are retrieved by wearable sensory units give better diagnostic opportunities. Observing a patient remotely can be greatly helped by these units and the best part about using these units are that they can give data even when the patients are at their homes or at work. A huge amount of data is being gathered and it is of no doubt that these data sets would be the basis of any medical treatment in the near future.
The concept of remote healthcare monitoring system was initiated in the early 2008 in order to cope up with the increasing healthcare demands of the population in collaboration with technology. As commented by Baig & Gholamhosseini (2013), remote healthcare monitoring system is considered as an extension of the medical facility that helps in monitoring the vital body state of the patient. Remote monitoring is one of the healthcare sort technologies that facilitates the patients in using a mobile medical device in performing of a schedule test and sending the data to the professionals related to healthcare in real-time. Remote monitoring technology takes into consideration the regular monitoring devices like the meters of glucose for patients having diabetes, heart or blood anxiety monitors for the patients receiving care for cardiac treatment (Landolina et al., 2012). This data can be send to the office of general practice with an internet connection along with an application for software installed in a computer, tablet or Smartphone in the patient’s home. The information is being stored within a database so the professional of healthcare can evaluate the data.
As mentioned by Pawar et al., (2012), remote healthcare monitoring is a technological advancement that allows monitoring of the patients outside the conventional hospital settings. Therefore, the access to care eventually increases along with reducing the healthcare delivery costs. It can be seen that incorporating remote healthcare monitoring significantly improves the quality of the patient’s life. Remote healthcare monitoring provides required independence to the patients by preventing complications and reducing personal costs. Additionally, implementation of remote healthcare monitoring helps in delivering care right at the home. Using remote healthcare monitoring for ensuring care at home due to which the family members feels comfortable and relaxed. This is because they are aware that the patients are being monitored continuously along with providing sufficient support in the areas of healthcare problems (Banaee, Ahmed & Loutfi, 2013).  
The remote healthcare monitoring is a dominantly used technology in healthcare facility and is used as a working model. As commented by Baig, Gholamhosseini & Connolly (2013), one vital sign is monitored by the remote healthcare monitoring system whose data is transmitted to the healthcare professional. However, as argued by Aminian & Naji (2013), few remote healthcare monitoring systems helps in monitoring all the vital signs of the patient as well as conducting video recording. The data derived from the remote healthcare monitoring system are sent to the clinical practitioners for diagnosis and treatment. The basic remote healthcare monitoring systems include the set top box, blood pressure monitor, pulse oximeter, blood glucose meter, ear temperature, body temperature, spirometer and accelerometer.
Set top box: Set top box is the most important part of the entire set up as this helps in running the software application. The main function of the set top box includes deriving physiological data of the patient from different medical devices and transmitting them in real time data in presence of secured internet connection that is connected to either personal computer or laptop (Istepanian, Laxminarayan & Pattichis, 2014).
Blood pressure monitor: The blood pressure monitor is a wireless Bluetooth devise that measures the systolic and diastolic contraction of blood within the body along with the pulse rate. The blood pressure monitor is easy to operate and records the contractions at a user defined time (Dicks et al., 2012).
Pulse oximeter: The pulse oximeter helps in effective recording of the oxygen saturation as well as the heartbeat continuously. The pulse oximeter is also a wireless Bluetooth devise that records the vital data from the patient and transfer it into real time data.
Blood glucose meter: The use of this devise helps in recording the blood sugar level of the patient thereby, keeping the clinical practitioners updated. This is also a wireless Bluetooth devise that helps in real time transfer of data to the laptop or personal computer.
Ear temperature: The ear temperature machine helps in monitoring the temperature of the ear continuously.
Body temperature: The machines for monitoring the body temperature of the patients are wireless Bluetooth devise that helps in detecting the probability of health complications of the patients by the data derived from the machine.
Spirometer: The spirometer is a wireless infrared devise that records the FEV6 and FEVI readings.
Accelerometer: The accelerometer helps in detecting the fall of the patients by compact and continuous data collection from the patient thereby, preventing severe health complications.
There are number of factors that need to be considered while implementing or using remote healthcare monitoring systems. The remote healthcare monitoring systems basically runs in presence of internet connection. Therefore, in order to use remote healthcare monitoring systems the wireless connectivity of the clinical setting or the home needs to be operating without hindrances. As commented by Patel et al., (2012), for efficient and effective use of remote healthcare monitoring systems, the wireless connectivity options such as Wi-Fi, Bluetooth or infrared are significant. The size of the wearables plays a crucial role due to which the size of the wireless connectivity needs to be both efficient and compact. Compact and efficient wireless connectivity will thereby, ensure high connectivity speed at a wider range. In order to ensure efficient functioning of the wireless connectivity, the use of one consolidated module for Bluetooth and WI-Fi is suggested instead of using two different modules (Al Ameen, Liu & Kwak, 2012). In order to prevent harm to the human body, the rate of frequency of the wearables attached to the patient is extremely low. Therefore, the frequency level of the connectivity module needs to be within 10 GHz-20 GHz within a maximum range of 2 meters (Jara, Zamora-Izquierdo & Skarmeta, 2013).
However, as argued by Ong et al., (2016), the bio-health engineering and mobile device technology advancements are more significant. The clinical practitioners and the healthcare providers’ needs to ensure that the system developed should be able to meet the needs of the patients. The rise of mobile technology has resulted in the rise of wearable wireless sensor networks that is attached and implemented to the body of the patient. This helps in collecting required information by monitoring the physiological parameters and movements of the patients as well as the surrounding environment. The wearables attached to the patient have multiple sensors that is included with the sensor network in order to measure the effect of the surroundings on the patient (Ricci et al., 2013).
Since the initiation and implementation of remote healthcare monitoring systems, the quality of the healthcare has improved significantly. As commented by Klasnja & Pratt (2012), remote healthcare monitoring systems helps in monitoring the chronically ill as well as elderly people suffering from diseases such as diabetes, hypertension and cardiac problems. The better access to healthcare has helped in overall enhancement of health for the population. In the nation with increasing number of healthcare complications, remote healthcare monitoring systems has provided the clinical practitioners with the opportunity of treating more patients effectively and efficiently. However, as criticized by (Hassanalieragh et al., 2015), remote healthcare monitoring systems improves the quality the care provided within the clinical settings. Remote healthcare monitoring systems helps in connecting the clinical practitioners directly to the patient and the relevant data. As a result, it is easier for the clinical practitioners have access to the data of the patients daily thereby, easing the possibility of burnout. Improved quality of care due to RHMS results in obvious benefits to the patient care. Remote healthcare monitoring systems also ensures improved quality of care by creating a system of engaging the people more efficiently in accordance with their health (Watts, Ambrosia & Hinkley, 2012).
Implementation of remote healthcare monitoring systems helps in educating, providing support and feedback to the patients and their family. The RHMS helps in educating the patients of using the wearables in order to monitor the vital signs accurately. Educating the patients about the remote healthcare monitoring systems helps them understand the analogue signals easily along with the ability of operating the complex and difficult wearables. The use of RHMS provides an opportunity for the clinical practitioners to monitor the condition of the patients from a distance thereby, saving their life. The implementation of remote healthcare monitoring systems helps in mitigating the gap between the clinical practitioners and the patients. Additionally, the RHMS helps in monitoring the overall condition of the patients at a single time (Li et al., 2013).
In spite of having such significant uses of remote healthcare monitoring systems in improving the healthcare, the technology has encountered few challenges. As commented by Desai (2012), the patients find the technology of remote healthcare monitoring systems complex and inoperable. As a result, they are unable to use the technology appropriately. In order to measure the heartbeat, the wearable needs to be placed and positioned accurately. Therefore, due to the ignorance among the patients and the family, the wearables are not positioned and placed accurately that eventually hampers the data generation. Due to improper data generation, the diagnosis and the treatment of the patients are compromised and hampered.
However, as criticized by Silva et al., (2015), the cost of the remote healthcare monitoring systems is the major challenge that prevents the implementation of the system. The price of the remote healthcare monitoring systems are not affordable some of the population. As a result, in spite being significantly important, the remote healthcare monitoring systems remains inaccessible to the population. For example, in the rural area the remote healthcare monitoring systems is highly significant. However, due to low income and financial status, the rural population is unable to afford remote healthcare monitoring systems. Additionally, another challenge encountered while implementing remote healthcare monitoring system is acceptability by the users.  
The lack of knowledge and awareness about remote healthcare monitoring systems prevents the access of the facility by the patients. As the patients are unsure of the use and the significance, they prefer visiting the clinical practitioners during emergencies rather than using the facilities. Moreover, lack of infrastructure also prevents the use of remote healthcare monitoring systems at home. Having efficient wireless internet and Bluetooth connection are mandatory for implementing remote healthcare monitoring systems. It has been seen that the houses of the patients lacks appropriate infrastructure in terms of flawless connectivity that hampers the use of remote healthcare monitoring systems (Slotwiner et al., 2015).
The remote healthcare monitoring systems has several offerings to the patients as well as the clinical practitioners. As commented by Piette et al., (2012), the patients are provided with an opportunity to use remote healthcare monitoring systems on a mobile tablet or personal computer. Due to the use of personal devises, the patients are able to use RHMS at home thereby, ensuring improved and quality care continuously. However, as argued by Kallander et al., (2013), remote healthcare monitoring systems can be used as an intuitive and systematic guide depending on the pre-scheduled questions that should be answered. Additionally, the use of remote healthcare monitoring systems also helps in effortless integration with electronic devices such as blood pressure cuffs thereby, allowing in capturing data of the patient’s health shared in the RHMS.
The remote healthcare monitoring systems also influences the clinical practitioners by offering a centralised access and view of all the patients. Due to this advantage, the clinical practitioners are able to tailor the workflows, interventions and protocols thereby, developing customized care plans based on the condition and status of the patient (Solanas et al., 2014). Additionally, the use of remote healthcare monitoring systems helps in easy analysis of results by empowering them to adjust the treatment for the patients. The use of remote healthcare monitoring systems also triggers alarms that help the clinical practitioners to treat the patients accordingly. Moreover, the implementation of remote healthcare monitoring systems allows the clinical practitioners to provide sophisticated care by coordinating effectively with the multidisciplinary team of the organization and develop present and future interventions (Eschmann et al., 2012).
The remote healthcare monitoring systems have huge applications in the healthcare field. The application of remote healthcare monitoring systems helps in generating and gathering physiological data of the patient and provides treatment accordingly. The peripheral devices of remote healthcare monitoring systems include the blood pressure cuffs, glucometer and pulse oximeter. The implementation of the peripheral wearables helps in transmitting the generated data to the healthcare providers or associated third parties through wireless communication systems (Suryadevara & Mukhopadhyay, 2012). The use of remote healthcare monitoring systems is significant for the dementia patients. There are higher chances or risks of fall for the dementia patients those results to severe health complications. Therefore, remote healthcare monitoring systems promotes safety for the dementia patients by continuous surveillance. The sensors are attached to the patients thereby, allowing the clinical practitioners or the family members to detect the movement of the patient (Chae et al., 2012). Effective controlling of diabetes requires monitoring multiple parameters such as heartbeat, bold pressure, and weight and glucose level. Therefore, the use of peripheral sensory devises such as glucometer, blood pressure monitors and pulse oximeter.
The research possesses huge scope in the future for further studies as implementation of remote healthcare monitoring systems aim towards improving the healthcare scenario of the countries. Extensive research has been done while conducting the research. Therefore, the research can be used as a valuable secondary resource for the future researchers. Additionally, the future scope of the research lies in investigating to what extent the remote healthcare monitoring systems has been implemented in the rural population thereby, making it accessible to the population. Moreover, the rate of acceptance of remote healthcare monitoring systems by the population is also generates a future scope for the research.
According to Istepanian, Laxminarayan & Pattichis (2014), remote heath care monitoring system is an important part of health care market as it results in profitability. It enables the health care providers to obtain data related to health of a patient and transfer it to the respective doctors, surgeons, etc. The remote health care monitoring system has entirely changed the way in which the healthcare is provided to the patients. This enables the patients to get proper checkups without visiting the hospitals. The system also enables the doctors to regularly monitor the health conditions of the patients, which helps in avoiding medical emergencies. Additionally, the system also helps in reducing hospital readmissions (Maguire et al., 2015). Incorporation of remote health care monitoring system in chronic disease management is capable of enhancing the quality of life of the individuals. The system also helps in detection of health issues at an early stage, which helps in reducing the frequency of hospitalizations and the emergency visits. The system is also capable of decreasing the number of days of hospital stay of the patients. The system comprises of several technologies, which is dependent upon the type of disease and the aspects they monitor. The system helps in maintaining diabetes, reducing risk of heart attacks, preventing dementia and treating infertility. The importance of the system lies in the fact that the system helps the patients to obtain proper and timely treatment at an early stage. It enables multiple doctors to analyze the condition of the patients from remote locations. It helps the patients to save their time and energy by reducing the travelling. The remote health care monitoring systems have several advantages that increases their importance (Ma et al., 2017).  
According to Clark et al., (2015), the scope of remote health care monitoring system is very wide as in the fast changing world, the number of people affected by several diseases has also increased, which has made it difficult for the doctors and hospitals to manage the patients properly. Nowadays, people have too busy working schedules, which render them incapable of visiting the doctors within proper time. Therefore, remote health care monitoring system has come up as a solution to all the medical issues, which has made life of the people easier. The system helps the elderly patients, who are incapable of visiting the doctors frequently. The system also enables the individuals busy in their working schedule to get proper health checkups and treatments without spending much time in the process. The system helps in maintaining diabetes, reducing risk of heart attacks, preventing dementia and treating infertility. The doctors favor the system as it helps them to visualize the patient’s health in real-time and increasing their operational efficiency (Adibi, 2015). The system helps in reducing the workload and enhances the clinical productivity solution. It helps in saving the time and resources. The system has the potentiality of delivering constant and qualitative health care to the individuals in remote areas.  
In this chapter, it can be concluded that the implementation remote healthcare monitoring systems has enhanced and improved the healthcare facilities. The use of remote healthcare monitoring systems allows the clinical practitioners to closely monitor the patients and provide treatment. The use of remote healthcare monitoring systems has provided better access to healthcare facilities for the patients thereby, improving the quality of care and treatment. Additionally, remote healthcare monitoring systems also allows the clinical practitioners to provide sophisticated care to the patients. However, the price, the infrastructure and the lack of awareness regarding remote healthcare monitoring systems prevents the use largely.
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