IEEE Consumer Electronics Magazine - September/October 2020 - 48

Healthcare Cyber-Physical System

RELATED WORKS
Remote monitoring systems can improve
patient care.17 Blood pressure monitoring solutions can be considered as preventive, responsive, or regular care systems.15 Several works
have been realized to monitor blood pressure
remotely using context-aware systems.11-14
Santamore et al.11 developed an Internetbased system with two sensors to monitor the
physical-activity level using a pedometer, and
blood pressure using a BPM. These two sensors
were not able to transmit data automatically and
users had to enter measurements manually into
the system. By using only two sensors, authors
could not verify all recommendations regarding
blood pressure measurement. Kusk et al.12 presented a rule-based telemonitoring system to
study patients' acceptability of a blood pressure
surveillance system in their home. Patients were
equipped with a BPM, two passive infrared
movement sensors were used to verify that
patients were not moving during measurement,
and a microphone-based sensor checked the
sound level. A smartphone application was
developed to communicate with these four sensors and guided patients performing a blood
pressure measurement in line with noise and
rest recommendations. The remaining guidelines could not be verified as integrated sensors
are unable to measure requested data. Wijsman
et al.13 conducted a study to test the feasibility
of remote blood pressure monitoring. Despite
the diversity of BPMs, only Android users tested
a connected BPM, whereas iPhone users were
given a nonconnected one and were asked to
report measurements manually. In another
work, Lindahl et al.14 developed the ValidAid system, consisting of a BPM combined with a chair
equipped with pressure sensors in order to
detect rest time as well as back and legs positions. While the BPM was a commercialized one,
authors developed a specific device to detect
back and legs positions.
Table 2 summarizes the aforementioned
works in terms of recommended guidelines. In
none of these studies were all recommendations
respected before measuring blood pressure. Furthermore, in the article by Lindahl et al.,14 the
straight back and uncrossed legs conditions
were verified using research devices, which are

not widely available to the public. Also, privacy
was not systematically studied. An overarching
challenge is that current health sensors are
unable to communicate with each other, and are
thus unable to contextualize their measurements. Therefore, connected sensors have to be
improved so as to handle data provided by different types of devices and to enhance measurement reliability.

CONCLUSION
Blood pressure is an important vital sign to
monitor in order to control and treat cardiac
diseases but its measurement requires specific
conditions to be met in order to ensure reliability. According to recent studies, it is clear
that patients do not measure their blood pressure in compliance with clinical recommendations. Even if the IoT has the potential to
guide patients in performing reliable measurements, the current market situation offers
only the possibility for partial guidance.
Furthermore, very few sensors allow blood
pressure monitoring while preserving users'
privacy. Manufacturers should better document their devices' manuals to explain measurement recommendations. In addition, they
should enable direct sensor interoperability
to protect their clients' privacy.

ACKNOWLEDGMENTS
The authors would like to thank Prof. Dominique Somme for his fruitful discussions. This
work was supported by ANRT under Contract
915/2015.

& REFERENCES
1. H. Zhu et al., "Smart healthcare in the era of Internetof-Things," IEEE Consum. Electron. Mag., vol. 8, no. 5,
pp. 26-30, Sep. 2019.
2. J. Y. Kim, N. E. Wineinger, and S. R. Steinhubl, "The
influence of wireless self-monitoring program on the
relationship between patient activation and health
behaviors, medication adherence, and blood pressure
levels in hypertensive patients: A substudy of a
randomized controlled trial," J. Med. Internet Res.,
vol. 18, no. 6, 2016, Art. no. e116. [Online]. Available:
http://www.jmir.org/2016/6/e116/

IEEE Consumer Electronics Magazine

http://www.jmir.org/2016/6/e116/

IEEE Consumer Electronics Magazine - September/October 2020

Table of Contents for the Digital Edition of IEEE Consumer Electronics Magazine - September/October 2020