---

[attachment=7722]

INTRODUCTION

By deploying telecommunications technologies to deliver health care and share medical knowledge over a distance, telemedicine aims at providing expert-based medical care to any place and at any time health care is needed. When the first telemedicine services were provided, telemedicine applications were implemented over wired communications technologies such as plain old telephone network (POTN) and integrated services digital network (ISDN).Recent developments in telemedicine resulting from wireless advances are promoting wireless telemedicine, also referred to as m-health or mobile health. Normally, wireless telemedicine systems consist of wearable medical devices and wireless communications networks.
Wireless communications overcomes most geographical, temporal,and organizational barriers to the transfer of medical data and records.In order to provide ubiquitous availability of multimedia services and applications, wireless and mobile technologies are evolving towards integration of heterogeneous access networks such as wireless personal area networks (WPANs), wireless local area networks (WLANs), wireless metropolitan area networks (WMANs) as well as third-generation (3G) and beyond 3G cellular networks.
A hybrid network based on IEEE 802.11/WLANs and IEEE 802.16/WiMAX is a strong contender since both technologies are designed to provide ubiquitous low cost, high-speed data rates, quality of service (QoS) provisioning, and broadband wireless Internet access.IEEE 802.11/WLAN is the standard to provide moderate- to high-speed data communications in a short range generally within a building. The IEEE 802.16/WiMAX is the standard to provide broadband wireless services requiring high-rate transmission and strict QoS requirements in both indoor and outdoor environments.Various advanced medical applications such as remote follow-up, remote diagnosis, intervention on non-transportable patients, remote monitoring, remote assistance, and medical e-learning are expected to be improved by using WiMAX.


Mobile telemedicine systems can be deployed for emergency telemedicine services, mobile patient monitoring, and mobile health service provider. Security is a significant requirement for any communication environment; a mobile healthcare system with patient monitoring is no exception.Although real-time monitoring and data transmission provides necessary information quickly, it also can expose a patient’s medical data to malicious intruders or eavesdroppers.If an m healthcare system lacks the necessary protection when communicating data, unauthorized parties or persons can easily access the private data of a patient, medical records may be modified freely by malicious attackers, and false information can be injected into the data stream by a prohibited node.
As a result, when planning mobile health-care systems, security is indispensable because of the shared nature of wireless devices, the mobility of the patients, and the susceptibility of dynamic and pervasive environments. Due to the important function of m-healthcare, patient monitoring can be a vulnerable point by which an attacker may jeopardize the entire functioning of the system, and even mislead medical professionals to make improper decisions.
In this we study the issues of patient monitoring from the viewpoint of mobile healthcare, and show how current secure strategies are applied to achieve the security and privacy requirements.In next we briefly describe the reliability, efficiency and security issues of m-healthcare and BSNs. Subsequently,we focus on the techniques of patient monitoring and secure healthcare mechanisms. Finally,we present our conclusions.

WLAN AND WIMAX OVERVIEW

WLAN OVERVIEW
WLANs are commonly used in their 802.11a, 802.11b, and 802.11g versions to provide wireless connectivity in home, office, and some commercial establishments; they are also widely deployed in telemedicine systems. Since the early 1990s,the industrial, scientific, and medical bands,2.4GHz and 5 GHz, have been made available for WLAN, among which the 802.11b and 802.11g protocols are the most popular.IEEE 802.11 WLANs are most suitable for local telemedicine services, IEEE 802.11e can be used for transmitting sensitive medical data with QoS support, and IEEE 802.11i provides security support as an amendment to the original IEEE 802.11 standard by specifying securitymechanisms for WLANs. However, WLANs have limitations in terms of mobility and coverage area.
WIMAX OVERVIEW
IEEE 802.16/WiMAX is a good last-mile wireless access solution that provides baseline features for flexibility in spectrum to be used all over the world. Advantages of using WiMAX for wireless telemedicine applications over WLAN-based systems can be summarized as follows:
• Broadband wireless access in both fixed and mobile environments
• High bandwidth to reduce transmission delay of quality images significantly
• Integrated services provided by the large network capacity of WiMAX enabling fully functional telemedicine services such as various types of diagnostics, physical monitoring pharmaceutical and drug dosage management services, good quality conversational communications between a physician and a patient,and consultation among medical specialists

• Medium access control (MAC) layer security features of WiMAX providing access control and encryption functions for wireless telemedicine services
• QoS framework defined in 802.16e enabling efficient and reliable transmission of medical data
COMPARISON BETWEEN WLAN AND WIMAX
The most fundamental difference between WLAN and WiMAX is that they are designed for totally different applications.
• WLAN is the standard to provide moderate- to high-speed data communications within a short range, generally within a building.
• WiMAX is the standard to provide Internet access over a long range outdoor environment.
• All WLAN implementations use unlicensed frequency bands, but WiMAX can operate in either licensed or unlicensed spectrum.

---