telemedicine systems

7/31/2019 Telemedicine Systems

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Rohitash Gupta

2007A8TS442U


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Replacement for older versions of home care Integration of communication and medicinal

technology

Solution to the difficulties of transport for theelderly and too sick

Bypasses physical hospital restrictions

Top 3 Current Uses: Radiology, Dermatology,

Psychiatry


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More efficient use of a doctors time Ensures 1 to 1 care of every patient

Initial setup followed by easy maintenance

Can be used through a mobile phone No human error in dosage

Benefiting the society economically as well


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High maintenance, training and initial setupcost

Complex training requirements

People may not like the idea of a computerholding their life in its digital hands

Technical Breakdown

Overdependence on electricity and internet


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aka Heart Rate Monitor Measures multiple patient vitals

Heart Rate, Blood Pressure, Respiration,

Temperature and SPO2 levels With this information, diagnosis is easily

made


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Interprets electrical signals produced by heart

Recorded via electrodes attached to the skin

12 leads, 6 limb leads, 6 precordial leads

Each lead is bipolar, 1 negative, 1 positive

end


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P wave represents depolarization of both atria PR interval is generally about 0.12-2 seconds

QRS complex: Usually 0.08-0.12 seconds

Many different types of QRS complex


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Heart rate: to measure heart rate, we need toconsider the duration between twoconsecutive waveforms such as the R-Rduration

Rate = 60/(R-R Interval)

There are a lot more functions, but since thefocus is on the ECG as it pertains to the

telemedicine system, the focus is kept to itsmost common functions


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Is one of the main uses of telemedicine Treats many illnesses such as congenital

heart disease, myocardial infarction [MI],angina

Cardiovascular disease is the single leadingcause of death in the US

Telecardiology helps many hospital lower the

amount of legal ramifications of missed MIsor misdiagnoses


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It is a monumental task that requires a wholehost of factors to be considered Type of equipment being used

Networking operations

Expenses involved Demographic of location

Selection of an appropriate site

Plans for staff training, delays, emergencies

Client responsibilities Manpower requirements


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To keep it simple, I decided to go for a small-scale telemedicine system

It will be a compact system with the hostbeing in a small hospital and the client-sidecounter-part in a patients home

Staff involved will simply be the 2 doctorsassigned to the patient and the contracted

technicians for setup of the equipment atboth of the sites


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The patient lives in a fairly wealthyneighborhood

The clients area allows for fiber-optic cablesand flawless wireless internet at high-speeds

The hospital is located about 40km away in aslightly less affluent area however, theinternet is comparable to the clients

Nothing in the locations seems to indicatethat reliability will be an issue


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Price of a decent, small scale ECG: $15,000 Setting up a WWAN network with equipment

and installation charges: $12,000

Training of staff and clients: $8000

Ensuring QoS and maintenance: $2000

Setup of ECG and other overhead: $30,000

Fairly expensive process, casual estimates.

In the long run it may actually save the clientmoney if he has to visit the hospitalfrequently


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On top of staff training, I will have to ensurethat the client is fully informed about theprocess and that he is cognizant of hisresponsibilities in the telemedicine system

Since telemedicine systems have highbandwidth requirements that cant beprovided by a singular network, methodssuch as network striping to combine severalnetworks to form 1 high speed upload link toensure maximum performance will be needed


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GE MAC 5500 EKG Machine Has 12/15 lead analysis

Network used is going to be a dual-lane DSLconnection which usually limits uploadspeeds to 256k but by using network stripingand QoS handling, it can be boosted up toapproximately 1Mbps which is just about

enough for high definition video conferencing Cisco equipment used for network

propagation


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This system consists of a lightweight and power-saving wireless ECGdevice equipped with a built-in automatic warning expert system. Device is connected to a mobile, real-time display platform. The acquired ECG signals are instantaneously transmitted to mobile

devices, such as netbooks or mobile phones through Bluetooth, andthen, processed by the expert system.

An alert signal is sent to the remote database server, which can be

accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of

abnormal cardiac rhythms in real-time, including sinus tachycardia,sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiacasystole, which is very important for both the subjects who are beingmonitored and the healthcare personnel tracking cardiac-rhythmdisorders.

The proposed system also activates an emergency medical alarm systemwhen problems occur. Clinical testing reveals that the proposed systemis approximately 94% accurate, with high sensitivity, specificity, andpositive prediction rates for ten normal subjects.


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Ge MAC 5500 receives input

and sends it through wirelessinternet to a mobile phone

Patient(Client

Side)

Mobile receiver

Internet transmission from the mobilephone to the network setup at the healthcare center to receive and store theinformation output from the ECG

Doctor receives and processes

the information, then sendsback the diagnosis


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[9] Mats K. E. B. Walling MD, MSc t, and Samson Wajntraub,MSc t, Evaluation of Bluetooth as a Replacement for Cables inIntensive Care and Surgery, Critical Care and Trauma,Technical Communication, September 8, 2003.[10] Nathan. J. Muller, Bluetooth Demystified. Mc.Graw HallEdition,2000.[11] William Brims, Wireless ECG. vol .1[Online].[12] Haroon Mustafa Khan, Wireless ECG. vol .2. [Online].[13] Bhavik Kant. Wireless ECG. vol .3 [Online].[14] Brian Sense, Implementing wireless communication inhospital environments with Bluetooth, 802.11b, and othertechnologies.[15] Patrick O. Bobbie, Hema Chaudhari and Chaudary-Zeeshan Arif, Homecare Telemedicine: Analysis and Diagnosis

of TachycardiaCondition in an M8051 microcontroller. [Online][16] S. Ch.Voskarides, C.S.Pattichis, R.Istepanain, Practicalevaluation of GPRS use in Telemedicine System in Cyprus, inProc. 4th Conf on Inf.Tech Applns. In Biomedicine, U.K.2003,pp39-42.[17] GSM webpage: http:// www.gsmworld.com.World Academy of Science, Engineering and Technology 242006

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transmission through mobile phones ,J.Annals Academy Studenica,vol4,2001[6] I.Sachpazidis, @ Home: A modular telemedicine system, inProc. 2nd Workshop Mobile Computing in Medicine, Germany, 2002.[7] C.Kunze, U.Grossmann, W.Stork, and K.D.Muller-Glaser,Application of ubiquitous computing in personal health monitoringsystems, in Proc.36th Annu.Meeting German Society for Biomed.Eng., 2002[8] P.Bauer,M.Sichitiu,R.Istepanian and K.Premaratne , The MobilePatient: Wireless Distributed Sensor Networks for patient monitoringand Care, in Proc. IEEE EMBS International Conference onInformation Technology Applications in Biomedicine, Arlington,

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