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 the
elderly and too sick
Bypasses physical hospital restrictions
Top 3 Current Uses: Radiology, Dermatology,
Psychiatry
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More efficient use of a doctor’s 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 setup
cost
Complex training requirements
People may not like the idea of a computer
holding 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
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Recorded via electrodes attached to the skin
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12 leads, 6 limb leads, 6 precordial leads
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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 to
consider the duration between two
consecutive waveforms such as the R-R
duration
Rate = 60/(R-R Interval)
There are a lot more functions, but since the
focus is on the ECG as it pertains to the
telemedicine system, the focus is kept to it’s
most 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 leading
cause of death in the US
Telecardiology helps many hospital lower the
amount of legal ramifications of missed MI’s
or misdiagnoses
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It is a monumental task that requires a whole
host of factors to be considered
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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 smallscale telemedicine system
It will be a compact system with the host
being in a small hospital and the client-side
counter-part in a patient’s home
Staff involved will simply be the 2 doctors
assigned to the patient and the contracted
technicians for setup of the equipment at
both of the sites
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The patient lives in a fairly wealthy
neighborhood
The client’s area allows for fiber-optic cables
and flawless wireless internet at high-speeds
The hospital is located about 40km away in a
slightly less affluent area however, the
internet is comparable to the clients
Nothing in the locations seems to indicate
that 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 client
money if he has to visit the hospital
frequently
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On top of staff training, I will have to ensure
that the client is fully informed about the
process and that he is cognizant of his
responsibilities in the telemedicine system
Since telemedicine systems have high
bandwidth requirements that can’t be
provided by a singular network, methods
such as network striping to combine several
networks to form 1 high speed upload link to
ensure 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 DSL
connection which usually limits upload
speeds to 256k but by using network striping
and QoS handling, it can be boosted up to
approximately 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 ECG
device 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, and
then, 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 cardiac
asystole, which is very important for both the subjects who are being
monitored and the healthcare personnel tracking cardiac-rhythm
disorders.
The proposed system also activates an emergency medical alarm system
when problems occur. Clinical testing reveals that the proposed system
is approximately 94% accurate, with high sensitivity, specificity, and
positive prediction rates for ten normal subjects.
Internet transmission from the mobile
phone to the network setup at the health
care center to receive and store the
information output from the ECG
Patient
(Client
Side)
Ge MAC 5500 receives input
and sends it through wireless
internet to a mobile phone
Mobile receiver
Doctor receives and processes
the information, then sends
back the diagnosis
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lifestyle and food habits,” in Express Health Care Management
Magazine, 15th Dec,2004.
[2] B.Woodward, R.S.H.Istepanain and C.I.Richards, “Design of
Telemedicine system using a mobile Telephone,” IEEE Trans. inf.
Tech in Biomedicine,vol.5,no.1,march 2001
[3] Mohd Fadlee A. Rasid and Bryan Woodward, “Bluetooth
telemedicine processor for multichannel biomedical signal
transmission via mobile cellular networks,” IEEE Trans. inf. Tech in
Biomedicine, vol .9, no.1, 2005
[4] Jimena Rodriguez, Alfredo Goni, and Arantza Illaramendi, “Realtime classification of ECGs on a PDA,” IEEE Trans. inf. Tech in
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transmission through mobile phones ,” J.Annals Academy Studenica,
vol4,2001
[6] I.Sachpazidis, “@ Home: A modular telemedicine system,” in
Proc. 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 monitoring
systems,” in Proc.36th Annu.Meeting German Society for Biomed.
Eng., 2002
[8] P.Bauer,M.Sichitiu,R.Istepanian and K.Premaratne , “The Mobile
Patient: Wireless Distributed Sensor Networks for patient monitoring
and Care,” in Proc. IEEE EMBS International Conference on
Information Technology Applications in Biomedicine, Arlington,
[9] Mats K. E. B. Walling MD, MSc t, and Samson Wajntraub,
MSc t, “Evaluation of Bluetooth as a Replacement for Cables in
Intensive Care and Surgery,” Critical Care and Trauma,
Technical Communication, September 8, 2003.
[10] Nathan. J. Muller, Bluetooth Demystified. Mc.Graw Hall
Edition,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 in
hospital environments with Bluetooth, 802.11b, and other
technologies”.
[15] Patrick O. Bobbie, Hema Chaudhari and ChaudaryZeeshan Arif, Homecare Telemedicine: Analysis and Diagnosis
of Tachycardia
Condition in an M8051 microcontroller. [Online]
[16] S. Ch.Voskarides, C.S.Pattichis, R.Istepanain, “Practical
evaluation of GPRS use in Telemedicine System in Cyprus,” in
Proc. 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 24
2006