Exploiting Blockchain and Smart Contracts for Data Exploration As a Service

In collaborative environments, where enterprises interact each other’s without a centralised authority that ensures trust among them, the ability of providing cross-organisational services must be enabled also between mutually untrusting participants. Blockchain platforms and smart contracts have been proposed to implement collaborative processes. However, current solutions are platform-dependent and deploy on-chain the whole process, thus increasing the execution costs of smart contracts if deployed on permissionless blockchain. In this paper, we propose an approach that includes criteria to identify trust-demanding objects and activities in collaborative processes, a model to describe smart contracts in a platform-independent way and guidelines to deploy them in a blockchain. To this aim, a three-layered model is used to describe: (i) the collaborative process, represented in BPMN, where the business expert is supported to add annotations that identify trust-demanding objects and activities; (ii) Abstract Smart Contracts based on trust-demanding objects and activities only and specified by means of descriptors, that are independent from any blockchain technology; (iii) Concrete Smart Contracts, that implement abstract ones and are deployed over a specific blockchain, enabling the creation of a repository where a single descriptor is associated with multiple implementations. The flexibility and reduced costs of the approach, due to the smart contracts abstraction and the use of blockchain only when necessary, are discussed with a case study on remote monitoring services in the digital factory.

Introduction: Telemedicine is a growing field. Evidence around how remote monitoring in home mechanical ventilation (HMV) can impact upon patient experience, is lacking. Method: This review evaluated the impact of remote monitoring on the patient experiences of HMV. The patients were already established on HMV and selected according to their suitability for remote monitoring. A convenience sample of Ten patients was selected and were asked about their experiences of the HMV remote monitoring service. Results: A total of ten patients were randomly selected to participate in this survey. Three hospital admissions, ten hospital visits and two domiciliary visits have been avoided over the 1-year period, for these patients. All ten patients agreed that they felt reassured that their ventilation was being monitored by a physiotherapist. Nine patients reported that they would have been required to visit the UHS clinic to have changes made to their ventilator settings, if they were not being remotely adjusted. All patients reported that they felt their experience of HMV was improved by the addition of the remote monitoring. Two patients reported that they were more compliant with using their ventilator, as they had been selected for the remote monitoring service. Conclusions: These initial findings suggest that remote monitoring may have a positive impact upon patient experiences of HMV in terms of providing reassurance, reducing the need to attend hospital clinics and improving compliance with the treatment.

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): iRhytm Background Ambulatory ECG monitoring is needed to investigate intermittent heart rhythm symptoms. Traditional monitoring approaches are resource intensive, requiring multiple patient hospital visits and time-consuming analysis, using fixed capacity monitoring equipment. Purpose We carried out a 4000-patient pilot with an AI-led remote ECG monitoring service (Zio XT) to determine its impact on patients and the service. Single-use monitoring patches were sent directly to the patient to fit at home or fitted in outpatients. Patients wore the patch for 14 days of continuous monitoring and then returned it by Freepost for outsourced analysis and reporting. Methods We undertook a retrospective analysis of 200 consecutive patients attending for standard Holter monitoring, and compared this cohort with 200 consecutive patients who underwent monitoring with Zio. The Holter sample was taken from a time period prior to the introduction of the new remote service. Patients had been referred to cardiology for investigation of heart rhythm symptoms. Results The age ranges in the two groups were broadly comparable. In the Holter group, 100% of patients required a separate outpatient appointment to fit the monitor compared with 0% in the Zio group. Median time from monitor fitting to result was 18 days in the Zio group compared with 106 days in the Holter group (p<0.001). Test results were unavailable at follow-up in 16% of the Holter group compared with 2% of the Zio group (p<0.001). Arrhythmias were detected in more patients in the Zio group vs the Holter group (p<0.05), (SVT ≥ 30s 7.4% vs 0.5%; VT ≥ 8bts 10.5% vs 2.0%; Pause ≥ 3s 6.3% vs 2.5%; PAF 7.4% vs 2.5%). In the Holter group, 24 patients (12%) had no follow-up in cardiology outpatients. Of these, 9 were lost to follow-up and 3 deceased before completing the pathway. By comparison, 3 patients (1.6%) in the Zio group had no follow-up. In patients who had a follow-up appointment, 75% of patients in the Zio group had a non-face-to-face follow-up vs 48% in the Holter group (p<0.05). Repeat test was required in 11.5% of the Holter group compared with 4.7% of the Zio group (p<0.05). In the Holter group, 6 (3%) of the repeat tests were ILRs, compared with 2 (1.1%) in the Zio group. Conclusions Patients in the Zio group received their test results more quickly. Use of Zio XT resulted in fewer visits to hospital and a reduced need for repeat testing. Earlier detection of significant clinical arrhythmia, especially AF, facilitates rapid clinical decision making, and is expected to result in more patients receiving appropriate therapy.

Managing mpox using a remote monitoring service


 Throughout the COVID-19 pandemic, Canada’s health care system has experienced a dramatic shift toward virtual care. Patients with cardiac conditions are at an increased risk of adverse outcomes from COVID-19 infections, and for many, remote monitoring has been viewed as a safer form of health care delivery.
 This Policy Insight summarizes key facilitators and barriers to the implementation and expansion of remote monitoring programs for patients with cardiac conditions based on lessons learned during the COVID-19 pandemic. These include:
 
 Technology adoption — Health care decision-makers should be aware of barriers to technology adoption, including both patient and clinician hesitation and varying levels of health and digital literacy. Developing an effective education program to train staff and patients can help overcome technological barriers to adoption.
 Program adaptation — Transitioning programs to remote monitoring requires the consideration of a programs’ operational elements, such as eligibility requirements, onboarding and assessments, appointment logistics, program equipment, roles and responsibilities of clinicians and staff, health human resource planning, and data infrastructure and management.
 Regulatory and legislative changes — Policies that support enhanced interprovincial licensure and reimbursement for remote monitoring services are examples of policy changes that would foster a regulatory environment conducive to remote monitoring programs.
 
 
 While significant government investment has enabled the transition to virtual care (including remote monitoring), continued coordination between governments is needed to enhance the adoption of virtual care within Canadian health systems.
 Further research is needed on the cost-effectiveness and clinical appropriateness of remote monitoring across cardiac conditions. This analysis can support health system decision-makers in determining when and how to apply remote monitoring services safely and effectively.

In democratic societies including Iraq, electronic voting (e-voting) is an available option as a viable voting system. This system is more economically advisable than face-to-face voting by eliminating the need to pay poll staff. It may also make voting more accessible to the population with impairments and those living overseas. This study will propose an e-voting system based on smart contracts by using a decentralized private Blockchain. The proposed e-voting system will provide transparency, accuracy, fairness, eligibility, anonymity, verifiability, and immutability. This research proposed the most secure way of voting with the help of Blockchain using a mobile application that can be used to implement a large-scale solution and cost-effective. The Blockchain-based system has been designed in conjunction with the existing ECC cryptosystem to assure the dependability, anonymity, and security of votes and voters. The system that has been developed can be used to properly conduct elections, using a quick response code (QR Code), face recognition, and fingerprint for identification before casting a ballot to ensure eligibility. This results in using mobile smartphones in the voting process where voters can observe the transparency of their votes. Furthermore, eliminates the possibility of fraud and manipulation of the votes made due to the used blockchain for secure storage.

One of Smart City's goals is to reduce healthcare spending, also by prolonging the active and independent lives of the elderly. Often the elderly live alone; their lifestyle, including proper adherence to therapies, is often controlled by relatives or friends or caregivers by daily or weekly telephone calls. In addition to investigating energy and environment infrastructure and services, the project Brescia Smart Living wants to experience new remote monitoring services. The elderly is constantly monitored by a system of wearable and home sensors; a smartphone, acting as a home gateway, stores and elaborates data and reports events to one or more people chosen by the elderly person. The main result of the project is a very versatile and scalable sensory system, thanks to a framework that simplifies the management of several external devices in Android applications. An ambient assisted living application is presented, showing how the life style of an elderly person can be monitored in a non-invasive way.

Smart underwear was designed to meet the demands of elderly people be monitored in outpatient environments. Especially the demands of women have been addressed, who have heart failure but who still want to live in their home. The smart bra comprises textile electrodes and an ECG event recorder. The recorder transmits the data to the doctor only if artificial intelligence (AI) has discovered critical events in ECG signals. An implemented convolutional neural network, which uses the wavelet transformation of the ECG as input and to determine an interference index for this ECG signal is implemented. The smart bra can be part of new remote monitoring services such as e-consultation or as a new home-based follow-up to ensure seamless patient care after hospital or rehabilitation stays. Healthcare personnel has better access to the patient´s digital ECG data without direct consultation, independently of where the patient lives and the patient can feel safer.

The renewable energy industry's rapid growth creates a strong need for foundational networking infrastructure that can operate mission-critical services without interruption. NextEra Energy is one of the largest renewable energy producers worldwide and has complex wind and solar facilities that rely on an underlying network for both control systems, SCADA traffic, and regulatory compliance monitoring. Given the complexity of NextEra's operations, a failure of network connectivity could quickly result in a significant operational event in the energy space, affecting grid stability and regulatory compliance. Reworking network infrastructure in an organization like NextEra brings unique challenges regarding infrastructure scale, network complexity, and the requirement for continuous operations. Depending on the service delivery framework of the network tower, there may also be end-to-end service performance requirements applied to data centers, field offices, and remote generation sites. The difficulties in negotiating the integration of existing operational infrastructure with new infrastructure require modern approaches that successfully ensure they maintain continuous operations. Network resiliency includes ongoing monitoring, redundancy architecture, and business continuity planning. The unique complexity of regulatory compliance in the renewable energy space increases the requirement for reliability of network services because many compliance obligations are dependent on continual data transmission and remote monitoring services. Organizations that have similar operational infrastructures will find value in understanding proven frameworks that seek to

As a consequence of the COVID-19 emergency, frail citizens felt isolated because of social isolation, suspended and/or strongly reduced home assistance, and limited access to hospitals. In this sense, assistive technology could play a pivotal role in empowering frail older adults reducing their isolation, as well as in reinforcing the work of formal caregivers and professionals. In this context, the goal of this paper is to present four pilot studies—conducted from March 2020 to April 2021—to promptly react to COVID-19 by providing assistive technology solutions, aiming to (1) guarantee high-quality service to older adults in-home or in residential facility contexts, (2) promote social inclusion, and (3) reduce the virus transmission. In particular, four services, namely, telepresence service, remote monitoring service, virtual visit, and environmental disinfection, were designed, implemented, and tested in real environments involving 85 end-users to assess the user experience and/or preliminary assess the technical feasibility. The results underlined that all the proposed services were generally accepted by older adults and professionals. Additionally, the results remarked that the use of telepresence robots in private homes and residential facilities increased enjoyment reducing anxiety, whereas the monitoring service supported the clinicians in monitoring the discharged COVID-19 patients. It is also worth mentioning that two new services/products were developed to disinfect the environment and to allow virtual visits within the framework of a hospital information system. The virtual visits service offered the opportunity to expand the portfolio of hospital services. The main barriers were found in education, technology interoperability, and ethical/legal/privacy compliance. It is also worth mentioning the key role played by an appropriate design and customer needs analysis since not all assistive devices were designed for older persons.

One of the goals of Ambient Assisted Living (AAL) solutions is to extend the time that elderly people can live independently in their preferred environments by using ICT technologies for personal healthcare. However, in order to be optimal, remote monitoring services and health-related interventions should be strongly personalised to specific individuals’ requirements, preferences, abilities and motivations, which can vary among the elderly, and even dynamically evolve over time for the same person depending on changing user needs and context-dependent conditions. In this paper we present an End User Development (EUD) tool for the personalisation of context-dependent assistance by non-technical users in the AAL domain. In particular, we have considered applications for remotely monitoring and assisting elderly people at home through sending multimedia messages and reminders, as well as changing the state of various domestic appliances (e.g. lamps, heating system, TV) and devices available in the context surrounding the user. The design and development of the tailoring environment has been carried out in an iterative manner, informed by the feedback that was gathered through empirical evaluations done with older adults and caregivers.

BackgroundDue to seriously imbalanced distribution of follow-up clinics in China, routine in-office visits are erratically attended by many cardiovascular implantable electronic device (CIED) patients. Meanwhile, remote monitoring is significantly underutilized. Novel tools to address the current predicament of routine in-office visits in China is urgently needed.ObjectivesTo assess the reliability and feasibility of cloud follow-up in CIED patients.MethodsA total of 325 CIED patients from 13 hospitals in Sichuan Province, China, were enrolled. Information on patients’ sociodemographic and basic clinical characteristics was collected. All devices were tested and programmed with 5G-cloud follow-up platform in a real-time manner. All patients were surveyed about their acceptance of and preferences regarding cloud follow-up compared to routine in-office visits.ResultsCompliance with routine in-office visits in this region was 60.6%. None of the patients were enrolled in remote monitoring services. Clinically important predictors of non-compliance were elderly age (≥75 years old), odds ratio (OR) 2.392 (95% confidence interval, 1.111–5.150); needing notification from a follow-up clinic, OR 2.518 (1.179–5.376); and being beyond 15 months post-implantation, OR 5.440 (2.563–11.543). All cloud follow-up sessions were performed safely and efficiently, without any adverse events. 292 (89.8%) patients preferred cloud follow-up for future device management.ConclusionCompliance with routine in-office visits in this region has much room for improvement. Cloud follow-up addresses the limitations of an imbalanced distribution of follow-up clinics and geographic barriers for in-office CIED evaluation. Thus, cloud follow-up provides a potential solution to the current predicament of routine in-office visits in China.

Remote monitoring services are required to meet the very high demands on availability and efficiency of industrial systems. The fast evolution of technologies associated with the deeper penetration of Internet of Things in industry creates considerable challenges for such services. These are related to the whole data lifecycle, encompassing data acquisition, real-time data processing, transmission, storage, analysis, and higher added value service provision to users, with adequate data management and governance needed to be in place. The sheer complexity of such activities the need to ground such processing on sound domain knowledge emphasises the need for context information management. The aim of this paper is to survey and analyse recent literature that addresses Internet of Things context information management, mapping how context-aware computing addresses key challenges and supports delivering appropriate monitoring solutions.

The article studies the interaction between digital transformation and the legal field, analyzing the impact of digital technologies on legislation and legal practice. After outlining the basics of digital transformation, it examines how technological evolution affects the rule of law and the legal implications of digital transformation, with a focus on data protection and privacy in the digital age. Emerging legal tools such as smart contracts and blockchain technology present challenges and opportunities. Access to justice in the digital age is analyzed, noting the influence of technology on legal processes and online dispute resolution platforms. The paper also addresses the impact of digital transformation on legal education and the ethical issues associated with the use of technology in legal practice. In conclusion, the paper emphasizes the importance of adapting the legal system and educational practices to the changes generated by the digital transformation.

We live in a world that has historically been dominated by centralized, hierarchical organizations. Such organizations are characterized by (i) a centralized source of authority; (ii) a formal hierarchy with clearly defined “roles”; and, (iii) standardized operational systems and procedures dictated by that centralized authority/hierarchy. This type of organization has exerted an enormous influence on modern political, economic and social life, particularly in a business context. Regulatory models have been designed to support and sustain businesses organized in this way. Today, however, new digital technologies are disrupting this “old world” and introducing a shift in the practices and mindset of our society. New technologies are driving the emergence of “flatter”, more decentralized forms of organization. In this paper, we offer an analysis of how blockchain and related distributed ledger technologies are disrupting corporate organizations as an illustration of this broader “digital transformation.” The paper briefly introduces the digital transformation and main argument (Section 1); then considers how the digital transformation has led to the emergence of “platform” companies (Section 2). Since blockchain technology can be viewed as a next step in the “digital development” of a corporate organization, the paper then discusses the main features of blockchain technologies and smart contracts (Sections 3 & 4) and examines the often-made claim that these technologies are all just hype / a fad (Section 5). Section 6 explores why these technologies are so potentially disruptive in a business context and then introduces several examples of such blockchain-based business organizations, as well as possible future developments (Sections 7 and 8). Section 9 concludes.