1. The document discusses developing policy guidelines for machine-to-machine (M2M) communication in healthcare. 2. It provides background on M2M and projections for growth in connected devices, as well as frameworks for M2M in healthcare applications like remote patient monitoring. 3. The document outlines standardization activities around M2M in healthcare being carried out by the Telecommunication Engineering Centre and other international organizations, and important considerations to address in developing a policy framework.

1. 1
Machine to Machine (M2M) communication in
Health Care : Development of Policy Guidelines
by
A.K.Mittal
Sr.DDG & Head

2. 2
INDEX
Telecommunication Engineering center – A brief Introduction
What is M2M
M2M Projections
M2M frame work for health Monitoring
M2M Standardization
M2M Value Chain
International organizations working on standards
Policy Framework

3. 3
A brief introduction
1/2
 TEC develops standards for the telecommunication
sector in India and certifies telecom equipment as per
standard, in order to ensure development of world class
telecom network and smooth interconnection of individual
networks and devices in the country.
 TEC provides support and advice to DoT on technology,
spectrum and licensing related issues and produces
standards related documents.

4. 4
Telecommunication Engineering
Centre
2/2
TEC strives to enhance Indian contribution in the
development of international standards so that the
national interests are adequately safeguarded. Various
divisions in TEC chair the National working Groups
(NWGs) corresponding to the study group of ITU-T.
TEC also chair NWG-5 corresponding to study group 5
of ITU-R, which inter-alia deals standards for mobile
radio systems.
This is achieved through proactive, stakeholder
sensitive & responsive approach, knowledge sharing,
competency enhancement and continuance of a
conducive work culture.

5. 5
What is M2M?
A conceptual picture …
A “DEVICE”,
sensor, meter, etc.,
captures “something”,
e.g., location, level,
heat, motion, vital sign,
usage, etc.
that is transported through
a “NETWORK”
(wireless, wired or mixed)
to an “APPLICATION”,
which makes sense of
the captured data, e.g.,
stolen vehicle is
located, etc.
1/2

6. 6
Pipe (vertical):
1 Application, 1 NW,
1 (or few) type of Device
Horizontal (based on common
Service Layer)
Applications share common infrastructure,
environments and network elements
Business
Application
Communication
Things
representations
Network (mobile, fixed,
Powerline ..)
Local
NW
Devic
e
Gateway
Application Application
Communication
Network 1
Communication
Network 2
Local
NW
Devic
e
Devic
e
Devic
e
Things
representations
(shared)
Devic
e
Common Application
Infrastructure/Service layer
Gateway
IP
Business
Application #1
Business
Application #2
Business
Application #n
Applicatio
n Application
A A A A A
Things Things Things
2/2

7. 7
M2M Projections
Projections by research agencies
According to GSMA (GSM Association) and Machina Research (World’s
leading advisor on M2M, Internet of Things and Big Data), there may be 24
billion connected devices globally by 2020, having a business impact to be
worth US$ 4.3 Trillion.
According to the GSMA, this amounts to $1.3 trillion revenue
opportunities for mobile network operators alone spanning vertical
segments such as health, automotive, utilities and consumer
electronics.
 As per projections, Indian M2M market may rise from 30 Million devices in
2013 to more than 250 million in 2020.
M2M domain shall encompass no. of verticals such as Automotive (connected
vehicles), Energy (smart meters & smart grid), health care, security and
surveillance, Intelligent buildings, smart homes, smart city etc.
M2M applications will make the living smart and improve the quality of life.


8. 8
M2M framework for health monitoring
Personal Connected Health (PCH) allows providers and patients to:
 Use technology to collect data conveniently and securely
 Communicate more frequently with little manual intervention
 Effectively monitor and better understand personal health
data
It is broadly M2M in Health
1/4

9. 9
 Remote monitoring of patients after surgery, while resting
at home.
 Transmission of vital parameters of a patient from
ambulance to hospital.
 Remote monitoring of old aged patients.
 Remote consultation
 e-ICU
2/4

10. 10
Applications
© ETSI 2014. All rights reserved
Applications
Things
representations
Communications network
Field area network
A
Device
A
Device
A
Device
GW
A
Device
Things
Blood
pressure
Pulse
oximeter
Smart phone serving
as an M2M device
Pedometer Smart
bandage
Communications network
Linked things and digital
representations
3/4

11. 11
Remote patient monitoring / assisted living is the service category
currently identified by FG M2M as work focus in ITU. E-health
ecosystem is shown below
◦
4/4

12. 12
M2M Standardization
Open Process: Developing Design Guidelines
Development Life Cycle
1. Submission of ideas
2. Use Case development
3. Decomposition into Work Items
4. Gap Analysis
5. Guidelines Development
6. Approval
7. Testing
8. Public Release & Comment
Period
Use Cases
Requirements
Standards
Guidelines
1/4

13. 13
M2M Standardization activities in TEC
Working Groups in M2M domain formed in TEC
It is a new area taken up by TEC for standardisation. To begin with following
sectoral working groups have been formed :
 Vehicle Telematics
 Power (Smart Grid & Smart Metering)
 Health (e-Health, M-Health, Telemedicine)
 Security & surveillance
2/4
M2M Gateway & Architecture working group has also been setup to develop a
common M2M service layer, involving stakeholders from the M2M and
vertical market communities which would provide a cost-efficient platform and
can be easily deployed in hardware and software, in a multi-vendor
environment, and across sectors.

14. 14
M2M Standardization activities in TEC
Members actively involved in Working group on M2M in Health
 Apollo Tele Health
 Biosense India
 Continua Health Alliance – India Working Group
 Deep Biz Technologies P Ltd.
 DeitY
 Ericsson
 ETSI
 HCL
 Huwaei
 iDiagnosis
 NIC
 Robonic India
 STMicroelectronics
 TCS
 TEC
 Tech Mahindra
 Track My Beat
 Wipro
3/4

15. 15
M2M Standardization activities in TEC
Working Group activities:- For framing specifications / standards
Working groups will, inter-alia, identify a minimum set of common
requirements of vertical markets, focusing on vertical related market and
application programming interfaces (APIs) and protocols supporting
applications and services, and draft technical reports in these areas.
 Working group will benefit from the work already carried out by any
other organization to the extent feasible to avoid duplication of work.
Working group will study standards and specifications developed / being
developed by international bodies such as ETSI, IEEE and OneM2M etc.
While preparing report / contribution, Indian interest will be kept in mind.
Working group are having con call every fortnight and F2F meeting
generally on quarterly basis.
F2F meeting along with Joint Working Group (JWG) meeting is being
scheduled this month to review the progress and carry the work forward.
4/4

16. 16
Machine Module Network Middleware
System
Integrator
Service
Provider
IC
Sensor
Transport
Modem
Gateway
Service
mgmt
Enablers
App’s
Customer
Service
Integration
Operations
End User
Middleware Providers
Service Providers
Network Equipment Providers
System Integrators
Application Developers
Machine & Device
Manufacturers
1/2

17. 17
M2M Value Chain
How to Connect ?
2/2
Enabling technologies for M2M
Sensor networks, Radio frequency Identification (RFID), Location-
Based Services (LBS), Lab-on-a-Chip (LOC) etc.
WiFi, ZigBee, Bluetooth, NFC, 6LOPAN for short range communication
(TAN, PAN, LAN)
(TAN- Touch area network, PAN- Personal area network, LAN- Local area network )
GSM 2G/ 3G/ 4G, WiMax, wire line broadband for long range
communication (WAN).
IPv6 capable of providing unique IP addresses to all the devices
available on earth as IP4 addresses are going to exhaust.

18. 18
International Organisations working on standards
WHO- World Health Organisation
ISO- International standards organisation
ITU- International Telecommunication Union
OneM2M – It is a partnership project created by 7 SDOs, that publish
telecom standards: TTC, ARIB (Japan), ATIS, TIA (USA), TTA (Korea)
CCSA (China), ETSI (Europe) to avoid creation of competing M2M
standards and are working to create standards for the common service
layer. It is having 226 members.
IEEE- Institute of Electrical and Electronics Engineers
W3C (World Wide Web Consortium) - W3C is an industry consortium
which seeks to promote standards for the evolution of the Web and
interoperability between WWW products by producing specifications and
reference software.
1/5

19. 19
International Organisations working on standards
 cen - European committee for standardization
 DICOM - The Digital Imaging and Communications in Medicine
(DICOM) standard is used for the exchange of images and related
information.
 GS1 - international organization that develops and maintains standards
for supply and demand chains across multiple sectors.
 HL7 - Health Level Seven, is a standard for exchanging information
between medical applications.
 epSOS - European electronic Health (e-health) interoperability project
co-funded by the European Commission and 47 beneficiaries. It focuses
on improving medical treatment of citizens while abroad by providing
health professionals with the necessary patient data. epSOS identifies
several means of interoperability which shall enable the use of cross-border
services
2/5

20. 20
International Organisations working on standards
3/5
 IHE (Integrating the health care enterprise) - It works to ensure
that all required information for medical decisions is accurate and
available to healthcare professionals. It defines a technical
framework for the implementation of established messaging
standards to achieve specific clinical goals.
 Continua - International non-profit industry organization enabling
end-to-end, plug-and-play connectivity of personal health devices,
systems and services in Personal Connected Health

21. 21
11073
Sensors
PAN Transport EHRs
4/5

22. Thermometer
Pulse Oximeter
Pulse /
Blood Pressure
Glucose Meter
Cardio / Strength
22
Health
Record
Network
(HRN)
Interface
Personal Device
Weight Scale
Independent
Living Activity
Peak Flow
Medication
Adherence
Physical Activity
Electrocardiogram
Insulin Pump
Aggregation
Manager
Personal
Area
Network
(PAN)
Interface
Telehealth
Service
Center
Wide
Area
Network
(WAN)
Interface
Health
Records/
Networks
PHR
EHR
NHIN
HIE
WiFi, 2G, 3G &
4G
5/5

23. 23
 Interoperability
 Conformance
 Security & Privacy of data
 KYC norms
 EMF radiation norms
1/6

24. 24
Policy Framework
Policy formation activities
DoT circulated a questionnaire to various stake holders expected to be
in M2M value chain . These includes
Academia /Consultants
Application/Content Developers/ System Integrators/ Equipment
vendors
End User
Associations
Telecom Service Providers
Government organisations
2/6

25. 25
Responses were summarized in 27 questions on policy and
their probable answers.
Discussions are going on, to stream line the various issues.
Meetings / Conferences held along with all stakeholders
including industry associations.
3/6

26. 26
Policy Framework
Important points to be addressed in the policy
The policy need to be forward looking, technology neutral,
flexible, addressing end to end M2M requirements and able to
promote competition with focus on standardization of devices,
interfaces and services covering almost all the verticals.
The data ownership and security also need to be addressed
along with separate classification of M2M connections by
TSP’s.
Issues pertaining to KYC, Certification of devices and
services, role of stake holders need to be enumerated.
SIM ownership, transferability, security and management
issues are to be addressed afresh for M2M domain.
4/6

27. 27
5/6
M2M devices and sensors need to be IPv6 based.
Policy should focus on IPv6 roll-out, standardization of devices and
application for universal adaptability.
Use of Cloud based applications shall be governed to the extant
Cloud policy of the Government.
Security standards and Interoperability standards have to be
defined
Guidelines for including M2M adoptions in all national infrastructure
projects will need to be worked out.
Coordination with BIS.

28. 28
M2M devices need to conform with safety standards from
radiation/ power perspectives.
Open standards and protocols.
Compatibility of devices and applications with SIM
management platform.
M2M devices need to be certified, while focusing on
international standards deployment.
6/6

29. 29