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A Project presentation onDesign of Assistive technology

for telehealth Application By:

Batch no : 1612 M. Goutham (12121A0466)

M. Thanusha (12121A0465)

A. Srikanth (12121A0402) C.P. Rupesh (12121A0410)

Guide:Ms. H. D. Praveena, M.Tech., (Ph.D) Assistant Professor,Dept of ECE.

Department of ECESREE VIDYANIKETHAN ENGINEERING

COLLEGE(AUTONOMOUS)

(AFFLIATED TO JNTU ANANTAPUR, APPROVED BY AICTE)SREE SAINATH NAGAR, A. RANGAMPET, TIRUPATI -517 102, A.P

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Outline• Objective

• Telehealth System and its advantages

• Heart Diseases and home care cardiology

• Vital Body parameters

• Existing Instrumentation and its challenges

• Design Goals

• Proposed method• Hardware and Software Development• Results

• Conclusion and Future Scope• References

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Objective• Designing a low cost Biomedical kit that can measure vital body signs

like Heart rate, Pulse rate and Blood Pressure.• Integrating the obtained results and displaying them on a smartphone

application.

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Telehealth system• Technique which uses telecommunication and

information technologies to provide clinical health care for people at distance.

• It helps in eliminating distance barriers • It can improve access to medical services that

would often not be consistently available in distant rural communities.

• It is also used to save lives in critical care and emergency situations.

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Advantages of Telehealth system• Telehealth consultancy can be beneficial to patients living in isolated

communities and remote regions.• Healthcare professionals in multiple locations to share information

and discuss patient issues as if they were in the same place.• Reduce the need for outpatient visits and enable remote prescription

verification and drug administration oversight thereby reducing the cost.

• Telehealth consultancy can also eliminate the possible transmission of infectious diseases or parasites between patients and medical staff.

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Heart Diseases• Heart disease is the number one cause of death for both men and women in the world.

• Cardiovascular diseases claim more lives than all forms of cancer combined.

• Statistics from World Health Organization

– Heart disease kills one person in every 5 seconds

– 7.6 millions of death worldwide each year

• Common types of heart problems

– Heart rhythm disorder: Irregular beats

– Coronary heart disease: Cannot supply adequate circulation to cardiac muscle cells

– Tachycardia: Heart beats very fast even whilst at rest

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Heart Diseases (contd.)• In a 2005 survey, most respondents—92%—recognized chest pain as

a symptom of a heart attack. Only 27% were aware of all major symptoms and knew to call 9-1-1 when someone was having a heart attack.

• About 47% of sudden cardiac deaths occur outside a hospital. This suggests that many people with heart disease don't act on early warning signs.

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Home care cardiology• Monitoring vital body parameters at home.• Cardiac events can occur irregularly and not during the doctor's office.

By doing home ecg monitoring, the condition can be captured and saved to be analysed by a doctor at a later time.

• The best time to take a reading is when you are not feeling well and experienced some warning signs of heart attack.

• After assessing the condition, the patient or care taker may call the doctor and get necessary treatment through telehealth or can reach the nearby hospital if severe.

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Vital Body parameters• The three main vital signs routinely monitored by medical

professionals and health care providers include the following:

• Heart Rate

• Pulse Rate

• Blood Pressure

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• Heart Rate

• Heart rate is the number of times a person's heart beats per minute.

• Continuous monitoring of heart rate is necessary for cardiac patients such that any

irregular heart rate seeks the doctor’s attention.

• Pulse Rate

• The pulse rate is measured when heart pushes blood through the arteries.

• Taking a pulse not only measures the heart rate, but also can indicate the following:

• Heart rhythm

• Strength of the pulse

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• Blood Pressure

• The pressure exerted by circulating blood upon the walls of blood vessels.

• Blood pressure is important because the higher your blood pressure is, the

higher your risk of health problems in the future.

• High BP puts extra strain on your arteries and on your heart. Over time, this

strain can cause the arteries to become to become thicker and less flexible, or

to become weaker.

• If an artery becomes completely clogged up (known as a clot), this can lead to

a heart attack, a stroke, kidney disease or dementia.

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Existing Instrumentation• Electrocardiography (ECG or EKG) is the process of recording the

electrical activity of the heart over a period of time using electrodes placed on a patient's body.

• In a conventional 12 lead ECG - ten electrodes are placed on the patient's limbs and on the surface of the chest - The overall magnitude of the heart's electrical potential is then measured from twelve different angles and is recorded over a period of time.

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Existing Instrumentation(contd.)• Photoplethysmography (PPG) is a simple and low-cost optical

technique that can be used to detect blood volume changes in the microvascular bed of tissue.

• A PPG is often obtained by using a pulse oximeter which illuminates the skin and measures changes in light absorption.

• A conventional pulse oximeter monitors the perfusion of blood to the dermis and subcutaneous tissue of the skin.

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Challenges in Existing Instrumentation• The Existing ECG and PPG are expensive, not portable, needs technical

skills and performs single activity at a place(Heart rate and Pulse rate individually).

• While it is a relatively simple test to perform, the interpretation of the ECG tracing requires significant amounts of training.

• Besides Blood pressure is an additional task needed to be measured which requires assistance.

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Challenges in Existing Instrumentation (contd.)• Raw ECG Signals often low in amplitude and distorted by noise sources

- Magnitude range: 0.1 to 5mV- Examples of Interference sources : muscle contractions power-line radiations

• Problem with having poor signal quality: Hard to obtain physiological insights- Low signal level -> Difficult to detect- High noise level -> May mask out useful clinical info

• All these challenges are considered and a simplified model is specified in our project.

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Design Goals• Low Cost• Portable• Safe measurement• Diagnosis at home• Single piece with many functionalities• Rapid and Sensitive• User friendly – simple to perform in a few steps with minimal training

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Instrumentational Amplifier

Optical Sensor

Filters

Filters

Arduino Uno - - - - - - - - - - - Mobile phone

Proposed Method

Results:1. Heart rate2. Pulse rate3. Blood Pressure

Patient

Bluetooth

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Project Structure• Design of ECG:

1. Instrumentation amplifier design2. Filter design3. Power source reduction4. Multi-lead ECG measurement

• Design of PPG:1. Filter Design2. Power source reduction3. PPG measurement using optical sensor

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Project Structure (Cont.)• Integrating the Data obtained from ECG and PPG we measure

the Blood Pressure of a person using the Arm length Algorithm

• Developing a Smartphone app:- Data acquisition from Arduino Uno via Bluetooth- Displaying the vital body parameters obtained from ECG

and PPG

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Hardware components

• Instrumentation Amplifier INA114

• Electrodes• Operational Amplifier-LM324• TCRT1000 • Diode -1N4007• Arduino Uno• HC-05 Bluetooth Module

• Arduino IDE• Android Studio• Filter Pro• Tina• Eagle

Software components

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Hardware Development• Heart Rate

++

-Rg

Rg

Ref

U1 INA128E

Ra 10k

R1 10k

+ VS2 12

+ VG2

+VS1 12

-

+ +U2 OPA228

R4 220

R5

470

C3 10mC4 10m

+

VS3 12

+ VS4 12

R9 1k

C7 1u

-

+ +U3 OPA228

C8 1u

+ VS6 12

+ VS7 12

+ VG1

-

+ +U5 OPA228

+ VS9 12

+ VS10 12

R10 100

R11 100k

R7 3.9k

+

VS8 5

-

+ +U4 OPA228

+ VS5 5C6 82

n

C5

330n

R8 3.9k

R6 12k

-

++U6 OPA228 + VS11 12

+ VS12 12

R2 10k

R3 1M

+ VG3

Inst Amp

HPF

LPF

SK MFB Inv Amp

Right Leg Ckt Frequency range : 0.1 to 150HzGain : 1000

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Pulse Rate

D1

1N11

83

C1 1uC2 1u

R2

68k

R1

68k

-

+ +3

2

6

74

OP1 !OPAMP -

+ +3

2

6

74

OP2 !OPAMP

R3 680k

C3 100nR4 6.8k

R5 6.8kR6 680kC4 100n

R7

33k

R8

220k

LED

1 C

QX3

5A

+ VS1 5

Photo Detector Output

BPF(0.1-2Hz)

Frequency range : 0.1 to 2 HzGain : 1000

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Software Development• The Output ECG and PPG are given as analog inputs to Arduino Uno

for further processing• The overall Software Development is broadly classified into two

sections• Arduino interfaced to hardware circuit which measures heart rate and pulse

rate• Android interfaced to Arduino through Bluetooth module

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Arduino Programming• Arduino is programmed to calculate

heart rate, pulse rate and Pulse transit time from the outputs of ECG and PPG

• Heart rate can be calculated by finding the Time interval between two consecutive R peaks in ECG output.

• Similarly Pulse rate can be calculated by finding the time interval between two consecutive peaks in PPG output.

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Arduino Programming (Contd.)• Pulse Transit Time (PTT) is the time it

takes the pulse pressure waveform to propagate through a length of the arterial tree.

• PTT can be used to estimate Blood Pressure

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Cuffless Blood pressure Estimation• As the blood flows through arteries, pressure waves propagate at a

certain velocity called pulse wave velocity (PWV).

• Based on these two equations, the BP can be computed from PTT assuming all other parameters are held constant.

The elasticity parameter E

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Cuffless Blood pressure Estimation(contd.)• BP estimation function

• Where PTT can be obtained from the time difference between ECG and PPG signals,.

• HR can be easily measured from the ECG, and BPn−1 is the previous BP estimate.

• The four coefficients (a,b,c and d) can be calculated by applying the least square method.

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Android Application• An Android app is designed to display all

the Vital parameters in an smart phone.• HC-05 Bluetooth module connects both the

Arduino and the app wirelessly to transfer data from Arduino to smart phone.

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Prototype

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Results• Heart Rate

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• Pulse Rate

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Conclusion• Providing quality and timely health assistance for elderly population is

a growing concern of both developed and developing nations.• Though there are high-tech hospitals and care centers for elderly, fact

that majority of them suffer from chronic disease and they require continuous monitoring of their physical parameters make it quite expensive.

• Our device can work independently at a home environment• Thus this device can really be a boon to elderly society by assisting

them in getting quality assistance at their own houses.

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Future Scope• This Telehealth Kit can be extended to

calculate other body parameters like Body Temperature, Respiration Rate and oxygen Saturation.

• Further the data obtained from telehealth kit can be stored in cloud storage and can be sent to doctors for the medical backups. Thus an e-health system can be developed

References[1] Kalvinder Singh, Patrick Crilly, Vallipuram Muthukkumarasamy, “Sensing and

analyzing physiological data with a smart phone to secure an e-health system”, in IEEE 2012 International Symposium on Communications and Information Technologies (ISCIT) , pp. 302 – 307.

[2] M. J. Gregoski, M. Mueller, A. Vertegel, A. Shaporev, B. B. Jackson, R. M. Frenzel, S. M. Sprehn, and F. A. Treiber, "Development and validation of a smartphone heart rate acquisition application for health promotion and wellness telehealth applications," International Journal of Telemedicine and Applications, vol. 2012, pp. 1-7, 2012.

[3] “Introduction to Biomedical Equipment Technology” by Joseph. J. Carr and John M. Brown.

[4] PulseSensor, "An Arduino device for measuring a human pulse, “http://www.pulsesensor.com/, 2012.

[5] Details of IR Base Hear Rate Sensor - www.sunrom.com[6] Arduino Uno data sheet - www.arduino.cc 33

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THANK YOU