The Internet of Things (IoT) has facilitated services without human intervention for a wide range of applications, including continuous remote patient monitoring (RPM). However, the complexity of RPM architectures, the size of data sets generated and limited power capacity of devices make RPM challenging. In this paper, we propose a tier-based End to End architecture for continuous patient monitoring that has a patient centric agent (PCA) as its center piece. The PCA manages a blockchain component to preserve privacy when data streaming from body area sensors needs to be stored securely. The PCA based architecture includes a lightweight communication protocol to enforce security of data through different segments of a continuous, real time patient monitoring architecture. The architecture includes the insertion of data into a personal blockchain to facilitate data sharing amongst healthcare professionals and integration into electronic health records while ensuring privacy is maintained. The blockchain is customized for RPM with modifications that include having the PCA select a Miner to reduce computational effort, enabling the PCA to manage multiple blockchains for the same patient, and the modification of each block with a prefix tree to minimize energy consumption and incorporate secure transaction payments. Simulation results demonstrate that security and privacy can be enhanced in RPM with the PCA based End to End architecture.

Purpose: The purpose of this paper is to describe an innovative information and decision support tool (ToolSHeD™) developed to help construction designers to integrate the management of OHS risk into the design process. The underlying structure of the prototype web‐based system and the process of knowledge acquisition and modelling are described.Design/methodology/approach: The ToolSHeD™ research and development project involved the capture of expert reasoning regarding design impacts upon occupational health and safety (OHS) risk. This knowledge was structured using an innovative method well‐suited to modelling knowledge in the context of uncertainty and discretionary decision‐making. Example “argument trees” are presented, representing the reasoning used by a panel of experts to assess the risk of falling from height during roof maintenance work. The advantage of using this method for modelling OHS knowledge, compared to the use of simplistic rules, is discussedFindings: The ToolSHeD™ prototype development and testing reveals that argument trees can represent design safety risk knowledge effectively.Practical implications: The translation of argument trees into a web‐based decision support tool is described and the potential impact of this tool in providing construction designers (architects and engineers) with easy and inexpensive access to expert OHS knowledge is discussed.Originality/value: The paper describes a new computer application, currently undergoing testing in the Australian building and construction industry. Its originality lies in the fact that ToolSHeD™ deploys argument trees to represent expert OHS reasoning, overcoming inherent limitations in rule‐based expert systems.

Introduction The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. Methods The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. Results It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19–AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67–AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30–AU$48.87) per resident. Discussion Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.