CN101073083B - 用于无线医疗设备可靠通信的消息完整性 - Google Patents

用于无线医疗设备可靠通信的消息完整性 Download PDF

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CN101073083B
CN101073083B CN2005800385588A CN200580038558A CN101073083B CN 101073083 B CN101073083 B CN 101073083B CN 2005800385588 A CN2005800385588 A CN 2005800385588A CN 200580038558 A CN200580038558 A CN 200580038558A CN 101073083 B CN101073083 B CN 101073083B
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CN101073083A (zh
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H·巴尔杜斯
D·S·桑切斯
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Koninklijke Philips NV
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • AHUMAN NECESSITIES
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    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0015Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system
    • A61B5/0024Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system for multiple sensor units attached to the patient, e.g. using a body or personal area network
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    • A61B5/316Modalities, i.e. specific diagnostic methods
    • A61B5/318Heart-related electrical modalities, e.g. electrocardiography [ECG]
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    • A61B5/352Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/903Radio telemetry
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/904Telephone telemetry

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Abstract

本发明涉及一种***(10),用于可靠地使医疗设备同步并提供带有时间性和唯一性的消息完整性,该***包括多个医疗无线设备(121、122、...12n)。医疗设备(121、122、...12n)相互无线通信。每条消息(M)包括数据部分和时间戳。每个医疗设备(121、122、...12n)包括附着于病人的传感器(14),用于监测共有的生命体征。当每个医疗设备的传感器(16)检测到生命体征功能的峰值时,医疗设备(121、122、...12n)进行同步。此时,每个医疗设备(121、122、...12n)的内部时钟归零,并且每个内部计时器开始计时。因此,医疗设备几乎在同一时刻进行松散同步。用由计时产生的发生时间TTSEND给每条产生的消息(M)打上时间戳。相对于接收方医疗设备内部时钟计数的接收时间TRECEIVE,对产生的消息(M)的时间戳TSEND进行验证。如果消息(M)超出预先指定的接受窗口,那么消息(M)被接收方医疗设备拒绝。

Description

用于无线医疗设备可靠通信的消息完整性
技术领域
本发明涉及医疗技术。本发明发现了与医疗无线设备相结合的特定应用,并且特别参照这方面对本发明进行描述。然而,应当理解,本发明也将应用于其他类似的医疗设备。
背景技术
无线医疗设备越来越多地应用于连续护理监测当中,从而在单个患者周围形成一个身体区域网络。当传感器节点附着于患者身体时,立即形成一个身体区域传感器网络。在身体区域网络中,医疗设备利用ZigBee、Bluetooth或其他现有短距离无线技术进行对等网络通信。每个医疗设备都提供一组医疗服务,并且可要求访问由其他设备提供的一组医疗服务。
确保无线医疗设备传输的信息和无线医疗设备之间传输的信息得到可靠保护是非常重要的。通常通过保证消息的保密性和完整性来确保医疗设备之间的无线通信安全。对通信数据进行加密,从而保护所传送的消息的内容,因此侵入者不能读出或修改消息。数据完整性机制确保了所传送的消息的完整性,因此入侵者不能通过修改消息和/或通过先窃听后重放(replay)消息来危及通信安全。例如,在重放攻击中,通信敌手起初可以窃听由授权通信方交换的加密信息,然后存储窃听到的消息,最终在经过一段时间之后,对窃听到的消息进行重放。因为重放的消息是以有效密钥进行加密的,所以通信方可能会将这些消息当作可靠消息而接受它们。将旧数据作为可靠数据而接受下来可能会带来严重后果,尤其在医疗领域,大部分传送的消息都包含患者的重要数据。通过提供带有唯一性(uniqueness)和时间性(timeliness)保证的消息完整性,可以消除这种担忧。
传统上,通过向待发送的消息加密绑定时间戳,比如,向消息附加时间戳并加密或计算由此产生的消息的MAC,提供了具有唯一性和时间性保证的消息完整性。解密接收到的消息之后,当且仅当附加的时间戳与授权的接收器自身当前时钟差异极小时,授权的接收器才接受该消息。通常,发送器和接收器具有它们自己的内部时钟,这些内部时钟与共有时间基准“松散同步”。在传统基础网络中,比如因特网或局域网中,计算机能可靠地从提供共有时钟的中央时间服务器取得共有基准时间。然而,在无线身体区域无线网络中,无线医疗设备进行通信时不需要专门连接到驻有时间服务器的任何基础网络中。另外,因为这些设备由电池供电,而每当医疗设备电池耗尽时会清除时间基准,所以这些设备在整个使用寿命中不能预先设置时间基准。另外,它们各自独立的内部时钟将随着时间变化而产生偏差。最后,因为消息唯一性和时间性的可靠性最终取决于时钟完整性,所以,时钟同步过程必须可靠,从而防止对手向后复位时钟以便恢复旧消息的有效性,或者防止对手向前设置时钟而为某些未来时间点做准备。
本发明提供一种新的和改进的装置及方法,可以克服上述相关难题。
发明内容
根据本发明的一个方面,公开了一种网络***。该***包括多个用于互相发送或接收消息的医疗设备,每条消息都包括数据部分和时间戳。每个医疗设备都包括附着于患者身体的传感器,至少密切地监测循环(recurring)的生命体征,还包括产生时间戳的时间戳产生装置。
根据本发明的另一个方面,公开了一种在医疗设备之间联网的方法。每个医疗设备都包括附着于患者身体的传感器。可靠地监测患者共有的至少一个循环生命体征。产生基于循环生命体征的时间戳。一个医疗设备向另一个医疗设备发送消息,并接收来自另一个医疗设备的消息。每条消息都包括数据部分和时间戳。
本发明的一个优点在于,自动地提供无线医疗设备的时间同步,而无需连接到外部服务器,以获得时间同步。
本发明的另一个优点在于,可靠的无线医疗设备同步,这些无线医疗设备的传感器附于同一患者的身体,在患者身体处产生了用于同步的生命体征。
本发明的另一个优点在于,无需用户介入即可提供无线医疗设备的时间同步。
本发明的另一个优点在于,取决于生命体征的重复模式而自动周期性地/间歇性地/偶然性地再次同步。
本发明的另一优点在于,降低了无线医疗设备同步所需的处理时间和通信开销。
本领域普通技术人员一旦阅读和理解了下列详细描述的优选实施例,则会相当清楚本发明更进一步的优点和益处。
附图说明
本发明可由各种组件和组件设置构成,并由各种步骤和步骤设置构成。附图的目的仅仅在于说明优选实施例,并不能理解是对本发明的限制。
图1是包括医疗设备的***的示意图;
图2是图1所示***的一部分的示意图;以及
图3是患者ECG图像直方图的示例图像。
具体实施方式
参考图1,***10用于可靠地使医疗设备同步并提供带有时间性和唯一性的消息完整性,该***包括多个医疗无线设备或装置或节点121、122、…12n,比如,ECG、血氧传感器、脉冲监测器、注射泵、滴液监测器等等。每个医疗设备121、122、…12n都包括传感器14,它通常放置于患者16的身体附近,或接触于患者16的身体,用于连续测量生命体征。每个医疗设备121、122、…12n更进一步地包括发送器18,它借助于传送/接收链路22、24,通过无线方式将生命体征测量数据传送到其他医疗设备或(可移动的)床边监测器20。医疗设备121、122、…12n运行通信协议,它使得第一医疗设备121将消息分发到其他医疗设备122、…12n。优选地,在附着于患者16之前,医疗设备121、122、…12n采用共享密钥进行初始化,从而确保通信的隐私性和真实性。在一个实施例中,一个或多个医疗设备121、122、…12n是移动装置,诸如无线生命体征传感器等等,它们可以直接附着于患者16。
继续参考图1,并且更进一步地参考图2和图3,第一医疗设备消息装置26产生并可靠地将经过加密和带有时间戳的消息M发送到第二医疗设备122。更具体地,每个医疗设备121、122都包括时钟同步装置或进程40、42,它们自动地使每个对应的医疗设备121、122的关联内部时钟44、46同步。每个对应的医疗设备121、122的峰值检测装置48、50都检测生命体征(例如,心搏)峰值,通常情况下,生命体征峰值是ECG信号的一个特征峰值。当峰值检测装置48、50检测到峰值时,每个对应的医疗设备121、122内部的计时器归零装置52、54将对应的内部时钟44、46设置为零,在这种情况下,每个对应的医疗设备121、122的内部时钟44、46开始计时。
在一个实施例中,为了提高效率,医疗设备121、122不再每当存在新的生命体征峰值就连续地进行同步,而是按照需要进行同步。更具体地说,不再由第一和第二峰值检测装置48、50不断地监测生命体征的峰值,而是由第一消息装置26激活第一峰值检测装置48,从而开始检测生命体征峰值。同时,第一消息装置26向通信***10的其他的医疗设备(诸如第二医疗设备122)传送“唤醒”广播。这样,第二医疗设备峰值检测装置50被激活了,然后它开始检测生命体征峰值。当第一和第二峰值检测装置48、50检测到峰值时,对应的第一和第二计时器归零装置52、54将第一和第二内部时钟44、46的内部时间设置成零。第一和第二内部时钟44、46开始计时。
第一时间戳产生装置60利用第一内部时钟44的计时来产生基于生命体征的时间戳TSEND,然后将产生的时间戳TSEND添加到消息M。加密装置62对带有时间戳的消息M进行加密,然后将消息M发送到第二医疗设备122的第二消息装置64。第二医疗设备解密装置66对包括附加时间戳TSEND的消息M进行解密。第二内部时钟46提供一个消息接收内部时间计数值TRECEIVE。第二医疗设备时间戳验证装置68相对于消息接收内部时间值TRECEIVE对时间戳TSEND进行验证。如果接收的时间戳TSEND与消息接收时间值TRECEIVE相比仅略有差异,即,TRECEIVE-ε≤TSEND≤TRECEIVE+ε,那么接受消息M。如果接收的时间戳TSEND与消息接收时间值TRECEIVE相比而言差异明显,即,TRECEIVE-ε≥TSEND≥TRECEIVE+ε,那么可认为消息M为重放消息,并且拒绝消息M。ε值必须选择合适的小数值,从而阻止消息重放。
在一个实施例中,在预定的暂停周期TTIMEOUT之后,同步过程40、42终止。
在一个可选实施例中,基于生命体征的时间戳包括自任意复位时间以后的周期性生理机能的重现次数的计数。比如,一个设备向全部设备发送复位或唤醒信号,会导致这些设备将计数器归零。此后,每个设备都计数自上一次复位以后所检测到的周期数,比如心搏周期的R波峰数量。这个计数提供了用于时间戳的相对时间信息。
作为另一种可选方式,时间戳是自上一次R-波峰或其他生命体征重现以后R波峰数量或其他生命体征重现数量的组合。
以上一参照优选实施例描述了本发明。一旦阅读和理解了先前的详细说明,其他人可以进行修改和变更。本发明包括落入所附权利要求及其等效内容范围之内的全部修改和变更。

Claims (17)

1.一种网络***(10),包括:
多个医疗设备(121、122、...、12n),用于监测患者,并从一个医疗设备向另一个医疗设备发送消息(M)或由一个医疗设备从另一个医疗设备接收消息(M),每个医疗设备(121、122、...、12n)包括:
传感器(14),所述传感器附着于患者(16),并监测患者的至少一个循环生命体征,其中所述至少一个循环生命体征对于所述多个医疗设备之中的第一医疗设备和第二医疗设备是共有的;
时间戳产生装置(60),其基于所述至少一个循环生命体征来产生时间戳,其中预定在第一医疗设备与第二医疗设备之间传送的消息中包括所述时间戳;和
同步装置,用于使第一医疗设备和第二医疗设备同步,从而评估表示消息离开第一医疗设备的发送时间的时间戳和所述消息到达第二医疗设备的接收时间之间的差异。
2.如权利要求1所述的***,其中每个同步装置(40、42)包括:
峰值检测装置(48、50),用于检测所监测的循环生命体征的峰值。
3.如权利要求2所述的***,其中每个同步装置(40、42)进一步包括:
计时器归零装置(52、54),当对应的峰值检测装置(48、50)检测到所述峰值时,所述计时器归零装置(52、54)初始化每个关联的医疗设备(121、122)的内部计时器(44、46),在这种情况下,每个初始化的内部计时器(44、46)开始新的计时。
4.如权利要求3所述的***,其中第二医疗设备包括:
时间戳验证装置(68),用于比较时间戳和接收时间(TRECEIVE),其中接收时间(TRECEIVE)对应于自第二峰值检测装置(50)检测到上一次峰值以来所测得的第二内部计时器(46)的时间标准量度。
5.如权利要求1所述的***,其中第一医疗设备进一步包括:
加密装置(62),用于在将所述消息发送到第二医疗设备之前,对所述消息(M)进行加密。
6.如权利要求3所述的***,其中自动执行所述同步。
7.如权利要求3所述的***,其中在所述医疗设备(121、122、...、12n)中的一个医疗设备进行请求的情况下,执行所述同步。
8.如权利要求1所述的***,其中所述时间戳表示自共有的复位时间以来循环生命体征的重现次数。
9.一种在多个医疗设备(121、122、...、12n)间联网的方法,其中每个医疗设备包括传感器(14),并且从一个医疗设备向另一个医疗设备发送消息(M),或由一个医疗设备从另一个医疗设备接收消息(M),所述方法包括:
将所述传感器(14)附着于患者(16);
监测所述患者的至少一个循环生命体征,其中所述至少一个循环生命体征对于所述多个医疗设备之中的第一医疗设备和第二医疗设备是共有的;
基于所述至少一个循环生命体征,产生时间戳,其中预定在第一医疗设备与第二医疗设备之间传送的消息中包括所述时间戳;以及
使第一医疗设备和第二医疗设备同步,从而评估表示消息离开第一医疗设备的发送时间的时间戳和所述消息到达第二医疗设备的接收时间之间的差异。
10.如权利要求9所述的方法,其中所述同步的步骤进一步包括:
由所述第一医疗设备和第二医疗设备检测所监测的循环生命体征的峰值;和
自动地将所述第一医疗设备和第二医疗设备同步到所检测到的峰值。
11.如权利要求10所述的方法,其中所述同步的步骤进一步包括:
当利用每个相关联的第一或第二医疗设备检测到所述峰值时,初始化相关联的第一或第二医疗设备的内部计时器(44、46);以及
在相关联的第一或第二医疗设备(121、122)的初始化的内部计时器中开始新的计时。
12.如权利要求9所述的方法,其中所述同步的步骤进一步包括:
比较时间戳和接收时间(TRECEIVE)。
13.如权利要求12所述的方法,进一步包括:
在将所述消息发送到所述第二医疗设备之前,在所述第一医疗设备上加密所述消息(M);
在加密之前,将时间戳添加到所述消息(M);
在所述第二医疗设备上,接收所述消息(M);以及
将所添加的时间戳与所述消息(M)到达所述第二医疗设备(122)的接收时间(TRECEIVE)进行比较。
14.如权利要求13所述的方法,进一步包括下列之一:
如果发送时间与接收时间相比仅略有差异,则在所述第二医疗设备上接受所述消息(M);以及
如果发送时间与接收时间相比而言差异明显,则在所述第二医疗设备上拒绝所述消息(M)。
15.如权利要求9所述的方法,其中所述同步的步骤包括:
由所述第一医疗设备和第二医疗设备开始对所监测的循环生命体征的峰值的检测;以及
当检测到所述峰值时,使每个相关联的医疗设备的内部计时器同步。
16.如权利要求9所述的方法,其中所述同步的步骤包括发送信号来将所述第一医疗设备和第二医疗设备二者复位,并且进一步包括:
计数所监测的循环生命体征的重现次数;以及
将所述计数并入所述时间戳。
17.如权利要求16所述的方法,进一步包括:
测量自所述循环生命体征的上一次重现以来的时间;以及
将所测量到的时间并入所述时间戳。
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