Application of an Internet of Medical Things (IoMT) to Communications in a Hospital Environment
Round 1
Reviewer 1 Report
This manuscript provides an IoMT application based on Sigfox communication paradigm.
Indeed, the post-covid era makes the urgency to develop IoMT solutions that alert health workers in time. However, the proposed solution does not provide an in-depth discussion.
1. The abstract does not provide the contributions of the proposed solution. It would be great if the author rewrite the abstract.
2. The organization of the paper could be improved. For example, there should be sections regarding related work, system model e.t.c.
3. In addition to the discussion of the communication paradigm the authors should consider including other IoMT solutions as a comparative analysis.
4. The result section does not provide a real use case scenario.
5. One of the important aspects that developers should care about is security while developing IoMT solutions. Medical data is private and sensitive. Unfortunately, the authors do not mention the security aspects of their solution. It would be great to have a dedicated security solution for the proposed application.
Author Response
- The abstract does not provide the contributions of the proposed solution. It would be great if the author rewrite the abstract.
The abstract was re-written with the summary of the research and the result, as well as the significance of the study.
- The organization of the paper could be improved. For example, there should be sections regarding related work, system model e.t.c.
Organization of the paper was edited with adding two related work/previous research with the difference this study suggests in the conclusion section.
- In addition to the discussion of the communication paradigm the authors should consider including other IoMT solutions as a comparative analysis.
Comparative analysis was added to the paper and the discussion section was improved with more in-depth contents.
- The result section does not provide a real use case scenario.
We put the real use case scenario of the study with data, more tables and figures (graph) were added for better visualization.
- One of the important aspects that developers should care about is security while developing IoMT solutions. Medical data is private and sensitive. Unfortunately, the authors do not mention the security aspects of their solution. It would be great to have a dedicated security solution for the proposed application.
Security aspect of the study was added specifically in the discussion section as well and with suggestions and limitation discussed.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Please see the comments below
1- The introduction has to be improved significantly. It looks like an abstract more than introduction. It is very short. The authors have to clearly state the significance of the proposed methodology in the introduction section.
2- Related Work section is missing. The authors have to summarize some relevant and latest survey articles and compare their contributions with the existing surveys. For example, they have to draw a comparison table in the related work section of all the paper included in the related work based on technical parameters
3- Experiments are not well explained. Results are very short. More explanation are needed
4- the authors have to highlight their contributions in the conclusion section.
5. The Limitations of the proposed study need to be discussed in the conclusion.
Author Response
- The introduction has to be improved significantly. It looks like an abstract more than introduction. It is very short. The authors have to clearly state the significance of the proposed methodology in the introduction section.
Introduction was edited with more information, combined with background information explanation of IoT and the significance and importance.
- Related Work section is missing. The authors have to summarize some relevant and latest survey articles and compare their contributions with the existing surveys. For example, they have to draw a comparison table in the related work section of all the paper included in the related work based on technical parameters
Organization of the paper was edited with adding two related work/previous research with the difference this study suggests in the conclusion section.
- Experiments are not well explained. Results are very short. More explanation are needed
We put the real use case scenario of the study with data, more tables and figures (graph) were added for better visualization.
- the authors have to highlight their contributions in the conclusion section.
Author contribution is written following the conclusion section.
- The Limitations of the proposed study need to be discussed in the conclusion.
Security aspect of the study was added specifically in the discussion section as well and with suggestions and limitation discussed.
Author Response File: Author Response.pdf
Reviewer 3 Report
Kim et al. demonstrated a proof-of-concept Sigfox-based IoT implementation in medical setting. The manuscript is unconventionally structured (more like a review paper rather than a research article) and key information is missing. Major adjustment is required before the manuscript is publishable.
1. Section 2 comprehensively introduced communication methods for the IoMT system. This should be the introduction of the paper. Beyond summarizing different communication methods at a high level, the authors should also introduce what has been done recently in the field and what is their advantages and disadvantages. These references will provide more insights in the field.
2. The actual method section is missing. It seems that Table 5 and Figure 10 is the main results from the authors. However, the authors fail to provide any details regarding these results - what devices were used, how many trials were made, how to calculate the accuracy. Without this information, the reviewer cannot evaluate the credibility of the presented data.
3. The current conclusion section should be the result section of an article. The authors need to interpret the results more thoroughly – why there is a difference in accuracy, what are the feasible methods to improve the accuracy etc.
4. All the figures should be referenced in the manuscript. Detailed descriptions are needed to illustrate what is happening in the figures.
Author Response
- Section 2 comprehensively introduced communication methods for the IoMT system. This should be the introduction of the paper. Beyond summarizing different communication methods at a high level, the authors should also introduce what has been done recently in the field and what is their advantages and disadvantages. These references will provide more insights in the field.
The section 2 was included in introduction and background rather than in materials and methods.
- The actual method section is missing. It seems that Table 5 and Figure 10 is the main results from the authors. However, the authors fail to provide any details regarding these results - what devices were used, how many trials were made, how to calculate the accuracy. Without this information, the reviewer cannot evaluate the credibility of the presented data.
Materials and methods section has been edited to include the relevant information of this study with details added.
- The current conclusion section should be the result section of an article. The authors need to interpret the results more thoroughly – why there is a difference in accuracy, what are the feasible methods to improve the accuracy etc.
We put the real use case scenario of the study with data, more tables and figures (graph) were added for better visualization.
- All the figures should be referenced in the manuscript. Detailed descriptions are needed to illustrate what is happening in the figures.
All the figures have referenced in the paper with detailed descriptions located in the contents.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
The authors have provided answers to most of the queries. However, a few comments remained unanswered.
1. It would be great to clarify the sensors used for the setup. The details of the devices are important to understand the implementation of the protocol.
2. The figures are difficult to read. it would be great if the authors improves the quality of the images.
3. The authors have motivated their use case with the COVID-19 pandemic situation. However, the accuracy of the data collection is not very high. It would be great if the authors provide clarification as the serious patient condition might be overlooked.
4. Although not the aim of the paper, nevertheless, important to mention the security aspects of the solution as during the pandemic many hospitals were the victim of cyber attacks.
Author Response
Response to Reviewer 1 (2) Comments
- It would be great to clarify the sensors used for the setup. The details of the devices are important to understand the implementation of the protocol.
Unfortunately depending on the availability and the setup, the sensors can be varied with different brands that can be implemented. The study focuses on the types of networks to be used; Sigfox, hospital and non-hospital networks, rather than the type and device of the sensors nor monitoring systems to be used as well as the infusion pumps, pharmaceutical refrigerators, and the receivers. We did not want to include specific brands of the sensors used in this article to avoid any further complication. The article mentions the type of sensors, location and temperature, used that would need to be compatible for IoT services/signals.
- The figures are difficult to read. it would be great if the authors improves the quality of the images.
All the figures include text/diagrams to visualize and demonstrate the system implemented, where all the explanations are narrated within the content of the article mentioning each figures. Figure 7, 8, and 9 were mislabeled which got fixed. If you could specify which figure that is hard to read, we can look into them.
- The authors have motivated their use case with the COVID-19 pandemic situation. However, the accuracy of the data collection is not very high. It would be great if the authors provide clarification as the serious patient condition might be overlooked.
As mentioned in the article, although the accuracy of the data collection is not high, the significance of this article is in that this is the actual implementation of the system using various networks in a hospital setting in Korea. We collected the data of location and temperature of certain devices (infusion pumps and pharmaceutical refrigerators) and patient/nurse. We mention that it would require improvement for implementation for patient conditions/health data, prescription, recommended treatment plans, surgical or hospital schedules, etc., which we look forward on studying in the future.
- Although not the aim of the paper, nevertheless, important to mention the security aspects of the solution as during the pandemic many hospitals were the victim of cyber attacks.
When the article covers the security/privacy of the participants with required consents as well as during collection of data, the data within the transition of information over signal and storage was not well mentioned previously. We included that all the data collected and stored as well as during transition was monitored, reviewed, and regulated by the medical information department of Severance Hospital with privacy policy and personal information protection guidelines -which is already processing all the health information of the patients within the hospital, they have specific protections against cyber-attacks themselves.
Author Response File: Author Response.pdf
Reviewer 2 Report
authors answer my questions and handle all mentioned concerns
Author Response
Thank you for your attention and concerns, we really appreciated for your time and effort for the reviews/comments given.
Reviewer 3 Report
All my comments has been addressed
Author Response
Thank you for your attention and concerns, we really appreciated for your time and effort for the reviews/comments given.
