Implementation of a WAP-based telemedicine system for patient monitoring

NextGen Public Health Surveillance and the Internet of Things (IoT)

Recent advances in technology have led to the rise of new-age data sources (e.g., Internet of Things (IoT), wearables, social media, and mobile health). IoT is becoming ubiquitous, and data generation is accelerating globally. Other health research domains have used IoT as a data source, but its potential has not been thoroughly explored and utilized systematically in public health surveillance. This article summarizes the existing literature on the use of IoT as a data source for surveillance. It presents the shortcomings of current data sources and how NextGen data sources, including the large-scale applications of IoT, can meet the needs of surveillance. The opportunities and challenges of using these modern data sources in public health surveillance are also explored. These IoT data ecosystems are being generated with minimal effort by the device users and benefit from high granularity, objectivity, and validity. Advances in computing are now bringing IoT-based surveillance into the realm of possibility. The potential advantages of IoT data include high-frequency, high volume, zero effort data collection methods, with a potential to have syndromic surveillance. In contrast, the critical challenges to mainstream this data source within surveillance systems are the huge volume and variety of data, fusing data from multiple devices to produce a unified result, and the lack of multidisciplinary professionals to understand the domain and analyze the domain data accordingly.

Machine learning in medicine: It has arrived, let's embrace it

Machine learning and artificial intelligence (AI) have arrived in medicine and the healthcare community is experiencing significant growth in their adoption across numerous patient care settings. There are countless applications for machine learning and AI in medicine ranging from patient outcome prediction, to clinical decision support, to predicting future patient therapeutic setpoints. This commentary discusses a recent application leveraging machine learning to predict one-year patient survival following orthotopic heart transplantation. This modeling approach has significant implications in terms of improving clinical decision-making, patient counseling, and ultimately organ allocation and has been shown to significantly outperform pre-existing algorithms. This commentary also discusses how adoption and advancement of this modeling approach in the future can provide increased personalization of patient care. The continued expansion of information systems and growth of electronic patient data sources in health care will continue to pave the way for increased use and adoption of data science in medicine. Personalized medicine has been a long-standing goal of the healthcare community and with machine learning and AI now being continually incorporated into clinical settings and practice, this technology is well on the pathway to make a considerable impact to greatly improve patient care in the near future.

Factors Affecting Use of Telemedicine and Telesurgery in Cancer Care (TTCC) among Specialist Physicians

Background: Considering the increasing incidence of different cancers, use of modern technologies such as TTCC can make a dramatic change in treatment of these diseases. So, if the evolution strategy conflicts with the organizational culture, national culture, and organizational structure of experts in this field, resistance will rise. Objective: The purpose of this study was to determine the effective factors on the use of TTCC in hospitals affiliated to Tehran University of Medical Sciences using the AHP model. Materials and Methods: This current descriptive study was carried out in 2018 on specialist physicians from five hospitals of Tehran University of Medical Sciences. The data gathering tool was a questionnaire consisting of two sections; demographic items and 27 effective factors influencing the implementation of TTCC technology, which was evaluated for validity and reliability. Data analysis was performed using analytical hierarchy process with expert choice and for empirical illustration are used to discuss the use of covariance-based SEM versus smart PLS software. Results: Based on AHP comparisons in the studied factors, the highest priority was the Cultural factor. In other words, commitment of senior executives to support the provision of a new technology with a weight of 0.327. The lowest priority, however, was related to support diverse approaches, innovation, creativeness, and acceptance of new ideas with a weight of 0.038. In regard with technical and organizational factors, out-of-hospital access to the intranet network and support provided by the doctors, with the weight of 0.221 and 0.205 in order, acquired the highest rates. Conclusion: Considering the high prevalence of cancer in Iran and the necessity of using new technologies in its treatment and by addressing the specialists’ views and opinions in this field, organizational and national culture in the application of TTCC technology should be promoted. This target can be hit through acceptance, change in attitude, and successful use of TTCC technology by medical professionals.

Wireless Patient Monitoring System for a Moving-Actuator Type Artificial Heart

In this study, we developed a wireless monitoring system for outpatients equipped with a moving-actuator type pulsatile bi-ventricular assist device, AnyHeart™. The developed monitoring system consists of two parts; a Bluetooth-based short-distance self-monitoring system that can monitor and control the operating status of a VAD using a Bluetooth-embedded personal digital assistant or a personal computer within a distance of 10 meters, and a cellular network-based remote monitoring system that can continuously monitor and control the operating status of AnyHeart™ at any location.

Results of in vitro experiments demonstrate the developed system's ability to monitor the operational status of an implanted AnyHeart™.

Foucault, surveillance, and carbon monoxide testing within stop-smoking services

Health professionals have adopted proactive testing for early evidence of disease. Researchers have identified that this leads to enumerated understandings and shapes behavior in productive ways. Smoking-cessation advisors regularly test clients for carbon monoxide (CO), but client views of this had not previously been explored. We interviewed 23 clients of a United Kingdom-based stop-smoking service regarding their experiences of CO testing. The majority of participants were successful quitters. We used ATLAS.ti 7 as a data-management tool during structured qualitative analysis. Our findings reveal that clients believed the results of their CO tests. Many became enumerated in their understanding, and thus placed themselves in a hierarchy with other members of their group. Almost all clients found that knowing their CO test score was motivating. We conclude that additional research is needed to understand the experiences of CO testing among clients who do not quit.

Improving compliance in remote healthcare systems through smartphone battery optimization

Remote health monitoring (RHM) has emerged as a solution to help reduce the cost burden of unhealthy lifestyles and aging populations. Enhancing compliance to prescribed medical regimens is an essential challenge to many systems, even those using smartphone technology. In this paper, we provide a technique to improve smartphone battery consumption and examine the effects of smartphone battery lifetime on compliance, in an attempt to enhance users' adherence to remote monitoring systems. We deploy WANDA-CVD, an RHM system for patients at risk of cardiovascular disease (CVD), using a wearable smartphone for detection of physical activity. We tested the battery optimization technique in an in-lab pilot study and validated its effects on compliance in the Women's Heart Health Study. The battery optimization technique enhanced the battery lifetime by 192% on average, resulting in a 53% increase in compliance in the study. A system like WANDA-CVD can help increase smartphone battery lifetime for RHM systems monitoring physical activity.

A wireless emergency telemedicine system for patients monitoring and diagnosis

Recently, remote healthcare systems have received increasing attention in the last decade, explaining why intelligent systems with physiology signal monitoring for e-health care are an emerging area of development. Therefore, this study adopts a system which includes continuous collection and evaluation of multiple vital signs, long-term healthcare, and a cellular connection to a medical center in emergency case and it transfers all acquired raw data by the internet in normal case. The proposed system can continuously acquire four different physiological signs, for example, ECG, SpO2, temperature, and blood pressure and further relayed them to an intelligent data analysis scheme to diagnose abnormal pulses for exploring potential chronic diseases. The proposed system also has a friendly web-based interface for medical staff to observe immediate pulse signals for remote treatment. Once abnormal event happened or the request to real-time display vital signs is confirmed, all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member's mobile phone or doctor's phone through GPRS. A prototype of such system has been successfully developed and implemented, which will offer high standard of healthcare with a major reduction in cost for our society.

Medical reliable network using concatenated channel codes through GSM network

Although the 4(th) generation (4G) of global mobile communication network, i.e. Long Term Evolution (LTE) coexisting with the 3(rd) generation (3G) has successfully started; the 2(nd) generation (2G), i.e. Global System for Mobile communication (GSM) still playing an important role in many developing countries. Without any other reliable network infrastructure, GSM can be applied for tele-monitoring applications, where high mobility and low cost are necessary. A core objective of this paper is to introduce the design of a more reliable and dependable Medical Network Channel Code system (MNCC) through GSM Network. MNCC design based on simple concatenated channel code, which is cascade of an inner code (GSM) and an extra outer code (Convolution Code) in order to protect medical data more robust against channel errors than other data using the existing GSM network. In this paper, the MNCC system will provide Bit Error Rate (BER) equivalent to the BER for medical tele monitoring of physiological signals, which is 10(-5) or less. The performance of the MNCC has been proven and investigated using computer simulations under different channels condition such as, Additive White Gaussian Noise (AWGN), Rayleigh noise and burst noise. Generally the MNCC system has been providing better performance as compared to GSM.

Clinical evaluation of a mobile heart rhythm telemonitoring system

Purpose. To evaluate the clinical applicability of a telemonitoring system: telemetric system for collection and distant surveillance of medical information (TEMEO). Methods. We evaluated 60 patients, applying simultaneously standard Holter ECG and telemonitoring. Two different comparisons were performed: (1) TEMEO ECG with standard 12-lead ECG; (2) TEMEO Holter with standard ECG Holter. Results. We found a very high coincidence rate (99.3%) between TEMEO derived ECGs and standard ECGs. Intraclass correlation coefficient analysis revealed high and significant correlation coefficients regarding average, maximal, and minimal heart rate, % of time in tachycardia, single supraventricular ectopic beats (SVEB), and single and couplets of ventricular ectopic beats (VEB) between Holter ECG and TEMEO derived parameters. Couplets of SVEB were recorded as different by the two monitoring systems, however, with a borderline statistical significance. Conclusions. TEMEO derived ECGs have a very high coincidence rate with standard ECGs. TEMEO patient monitoring provides results that are similar to those derived from a standard Holter ECG.

Mobile phone-enabled control of medical care and handicapped assistance

Mobile phones are now playing an ever more crucial role in people's daily lives. They are serving not only as a way of talking and delivering messages, but also for exchanging various information. Nevertheless, the functional limit of the phone is still far from being reached. Among the many promising applications, using mobile phones as an actuating element to control data or devices is useful in quite a few emerging medical care and handicapped assistance settings owing to its wireless communication feature. In this article, selected progresses of mobile phone-enabled controlling have been summarized, with more focus on evaluating its emerging roles in medical care. Several typical applications in the area are illustrated and some potential technical challenges and key issues worthy of pursuit are outlined. The intent of the article is to provide an elementary knowledge for people with different backgrounds, such as electrical or biomedical engineers, as well as people who are working on interdisciplinary areas. It is expected that medical care at any time and anywhere will be possible via the actuation platform provided by the mobile phone and mobile medicine will be pushed forward to a new height in the coming years.

AToMS: A Ubiquitous Teleconsultation System for Supporting AMI Patients with Prehospital Thrombolysis

The latest population-based studies in the medical literature worldwide indicate that acute myocardial infarction (AMI) patients still experience prolonged delay to be rescued, which often results in morbidity and mortality. This paper reports from a technological standpoint a teleconsultation and monitoring system named AToMS. This system addresses the problem of prehospital delivery of thrombolysis to AMI patients by enabling the remote interaction of the paramedics and a cardiologist available at a Coronary Care Unit (CCU). Such interaction allows the diagnosis of the patient eligibility to the immediate application of thrombolysis, which is meant to reduce the delay between the onset of symptoms and the eventual application of proper treatment. Such delay reduction is meant to increase the AMI patient's chances of survival and decrease the risks of postinfarction sequels. The teleconsultation is held with the support of wireless and mobile technologies, which also allows the cardiologist to monitor the patient while he/she is being taken to the nearest CCU. All exchanged messages among paramedics and cardiologists are recorded to render an auditable system. AToMS has been deployed in a first stage in the city of Rio de Janeiro, where the medical team involved in the project has conducted commissioned tests.

A WBAN-based real-time electroencephalogram monitoring system: design and implementation

In this study, a flexible wireless body area network (WBAN) node platform has been designed and implemented based on the Zigbee technology. In order to provide wide range WBAN for health monitoring, a Zigbee/Internet Gateway (ZiGW) has also been developed rather than using a PDA or a host PC to connect different WBANs by using the Internet as the communication infrastructure. The proposed body sensor node platform promises a cost-effective, flexible platform for developing physical sensor node in real-time health monitoring. The ZiGW can provide an effective method to connect WBAN with the Internet. In this work, we present the implementation of an Electroencephalogram (EEG) monitoring system using the proposed methods. In this proposed system, real-time EEG signals can be remotely monitored by physicians via Internet, and the collected EEG data is stored in the online EEG database which can be shared with physicians or researchers for further analysis.

A biomedical sensor system for real-time monitoring of astronauts' physiological parameters during extra-vehicular activities

OBJECTIVE

To design and test an embedded biomedical sensor system that can monitor astronauts' comprehensive physiological parameters, and provide real-time data display during extra-vehicle activities (EVA) in the space exploration.

METHODS

An embedded system was developed with an array of biomedical sensors that can be integrated into the spacesuit. Wired communications were tested for physiological data acquisition and data transmission to a computer mounted on the spacesuit during task performances simulating EVA sessions.

RESULTS

The sensor integration, data collection and communication, and the real-time data monitoring were successfully validated in the NASA field tests.

CONCLUSIONS

The developed system may work as an embedded system for monitoring health status during long-term space mission.

Mobile telemedicine: a survey study

Telemedicine involves the use of advanced and reliable communication techniques to deliver biomedical signals over long distances. In such systems, biomedical information is transmitted using wireline or wireless communication systems. Mobile telemedicine is an improved form of telemedicine, in which advanced wireless communication systems are used to deliver the biomedical signals of patients at any place and any time. Mobile telemedicine employs advanced concepts and techniques from the fields of electrical engineering, computer science, biomedical engineering, and medicine to overcome the restrictions involved in conventional telemedicine and realize an improvement in the quality of service of medicine. In this paper, we study several mobile telemedicine systems, and it is important to gain a good understanding of mobile telemedicine systems because in the further, such systems are expected to become ubiquitous for the delivery of biomedical signals for medicine.

Ubiquitous health monitoring system for multiple users using a ZigBee and WLAN dual-network

A ubiquitous health monitoring system for multiple users was developed based on a ZigBee and wireless local area network (WLAN) dual-network. A compact biosignal monitoring unit (BMU) for measuring electrocardiogram (ECG), photoplethysmogram (PPG), and temperature was also developed. A single 8-bit microcontroller operated the BMU including most of digital filtering and wireless communication. The BMU with its case was reduced to 55 x 35 x 15 mm and 33 g. In routine use, vital signs of 6 bytes/sec (heart rate, temperature, pulse transit time) per each user were transmitted through a ZigBee module even though all the real-time data were recorded in a secure digital memory of the BMU. In an emergency or when need arises, a channel of a particular user was switched to another ZigBee module, called the emergency module, that sent all ECG and PPG waveforms in real time. Each emergency ZigBee module handled up to a few users. Data from multiple users were wirelessly received by the ZigBee receiver modules in a controller called ZigBee-WLAN gateway, where the ZigBee modules were connected to a WLAN module. This WLAN module sent all data wirelessly to a monitoring center. Operating the dual modes of ZigBee/WLAN utilized an advantage of ZigBee by handling multiple users with minimum power consumption, and overcame the ZigBee limitation of low data rate. This dual-network system for LAN is economically competitive and reliable.

User inspection of National Taiwan University Hospital's telehealth care information system

The telehealth care system has been important in the healthcare world for several decades; however, Taiwan only began work on telehealth care this past year. This paper outlines the effectiveness of the telehealth care system developed by the National Taiwan University Hospital (NTUH). The usability of the integrated telehealth care system was analyzed through of heuristic evaluation and its usefulness. By using the heuristic evaluation form as developed by Nielsen, it is possible to examine the telehealth care system from the user's perspective. In addition, in assessing the usefulness through lists of criteria, system developers can determine the pros and the cons of the database. Ultimately, the heuristic evaluation revealed several violations on the system, but are not prohibitive to the development of such as system. Similarly, evaluation of the usefulness comes out positive; despite the fact that the suggested changes proposed by the users can be said are the main weaknesses of the system. With some improvements, the telehealth care system can be used efficiently in NTUH's healthcare system.

A cardiod based technique to identify cardiovascular diseases using mobile phones and body sensors

To prevent the threat of Cardiovascular Disease (CVD) related deaths, the usage of mobile phone based computational platforms, body sensors and wireless communications is proliferating. Since mobile phones have limited computational resources, existing PC based complex CVD detection algorithms are often unsuitable for wireless telecardiology applications. Moreover, if the existing Electrocardiography (ECG) based CVD detection algorithms are adopted for mobile telecardiology applications, then there will be processing delays due to the computational complexities of the existing algorithms. However, for a CVD affected patient, seconds worth of delay could be fatal, since cardiovascular cell damage is a totally irrecoverable process. This paper proposes a fast and efficient mechanism of CVD detection from ECG signal. Unlike the existing ECG based CVD diagnosis systems that detect CVD anomalies from hundreds of sample points, the proposed mechanism identifies cardiac abnormality from only 5 sample points. Therefore, according to our experiments the proposed mechanism is up to 3 times faster than the existing techniques. Due to less computational burden, the proposed mechanism is ideal for wireless telecardiology applications running on mobile phones.

Energy efficient simulator for patient monitoring in Body Sensor Networks

The medical tracking of patients carried out from a distance by means of wireless technology, incorporating various sensors simultaneously connected to the body of an individual, can promote health in suitable time. This article proposes a simulator for the monitoring of human health. This prototype simulates the workings of a BSN (Body Sensor Network) functioning as a sensor (electrophysiological signal) that is to be monitored, which utilizes a strategy based on the concept of data fusion. This tool incorporates a policy of economizing energy which has as its main objective increasing the operating time of the system.

An embedded mobile ECG reasoning system for elderly patients

With the increase in the number senior citizens and chronic diseases, the number of elderly patients who need constant assistance has increased. One key point of all critical care for elderly patient is the continuous monitoring of their vital signs. Among these, the ECG signal is used for noninvasive diagnosis of cardiovascular diseases. Also, there is a pressing need to have a proper system in place for patient identification. Errors in patient identification, and hence improper administration of medication can lead to disastrous results. This paper proposes a novel embedded mobile ECG reasoning system that integrates ECG signal reasoning and RF identification together to monitor an elderly patient. As a result, our proposed method has a good accuracy in heart beat recognition, and enables continuous monitoring and identification of the elderly patient when alone. Moreover, in order to examine and validate our proposed system, we propose a managerial research model to test whether it can be implemented in a medical organization. The results prove that the mobility, usability, and performance of our proposed system have impacts on the user's attitude, and there is a significant positive relation between the user's attitude and the intent to use our proposed system.

A mobile network-based multimedia teleconference system for homecare services

Because most research and development for homecare services have focused on providing connections between home and service centers, the goal of the present work is to develop techniques and create realtime communications to connect service centers and homecare workers in mobile environments. A key technical issue for this research is how to overcome the limitation of bandwidth in mobile media and networks. An effort has been made to balance performance of communication and basic demands in telehealth through optimized system design and technical implementation. Implementations using third generation (3G) Freedom Of Mobile multimedia Access (FOMA) and Personal Handyphone System (PHS) were developed and evaluated. We conclude that the system we developed based on 3G FOMA provides sufficient and satisfactory functions for use in homecare services.

A portable, low-cost, battery-powered wireless monitoring system for obtaining varying physiologic parameters from multiple subjects

A portable, low-cost, and battery-powered wireless monitoring system that is capable of measuring multiple physiologic parameters simultaneously from many subjects was developed. The wireless communication of data is based on a commercially-available mote known as Tmote Sky. The star network topology (SNT), is used to collect data from many patients via multiple motes. Application protocol software was developed to facilitate the communication link between the monitor terminal and multiple motes. Based on the standard specifications of the mote, the SNT strategy, and the application protocol software design, a single mote can support up to 5 electrocardiogram signals with a sampling rate of 200 Hz. This capability facilitates affordable wireless monitoring of multiple physiologic signals from many subjects; its application is especially attractive for monitoring subjects in nursing homes, battlefields, and disaster scenarios.

ECG signal denoising and baseline wander correction based on the empirical mode decomposition

The electrocardiogram (ECG) is widely used for diagnosis of heart diseases. Good quality ECG are utilized by physicians for interpretation and identification of physiological and pathological phenomena. However, in real situations, ECG recordings are often corrupted by artifacts. Two dominant artifacts present in ECG recordings are: (1) high-frequency noise caused by electromyogram induced noise, power line interferences, or mechanical forces acting on the electrodes; (2) baseline wander (BW) that may be due to respiration or the motion of the patients or the instruments. These artifacts severely limit the utility of recorded ECGs and thus need to be removed for better clinical evaluation. Several methods have been developed for ECG enhancement. In this paper, we propose a new ECG enhancement method based on the recently developed empirical mode decomposition (EMD). The proposed EMD-based method is able to remove both high-frequency noise and BW with minimum signal distortion. The method is validated through experiments on the MIT-BIH databases. Both quantitative and qualitative results are given. The simulations show that the proposed EMD-based method provides very good results for denoising and BW removal.

Adaptive transmit diversity with orthogonal space-time block coding for telemedicine application

Recently an adaptive transmit eigenbeamforming with orthogonal space-time block coding (Eigen-OSTBC) has been proposed. This model was simulated over macrocell environment with a uniform linear array (ULA) at the base station (BS) for next-generation (NG) wireless/mobile network. In this paper, we introduce a telemedicine simulation framework employing the Eigen-OSTBC scheme for the investigation of communication system characteristics in the application of biological data such as electrocardiogram (ECG). The geometrical-based hyperbolically distributed scatterers (GBHDS) channel model for macrocell environments was simulated with angular spreads (AS) taken from measurement data. Simulation results showed that the performance improvement introduced by the Eigen-OSTBC scheme can be observed even without extensive numerical analysis as traditionally expected. It is also showed that the received signal is highly correlated with the original transmitted signal.

Design and implementation of a framework for monitoring patients in hospitals using wireless sensors in ad hoc configuration

Patients in hospital intensive care units (ICUs) have to be monitored constantly. Typically, unless the attending physician is at the bedside, he or she has no information of the patient's progress, and must be paged manually in case of emergencies. A far better system would be one that keeps the patient's information available to the doctor or nurse at all times, possibly through the use of a handheld device. The doctor would then be able to check on the patient's progress in real time. Should an emergency arise, the doctor would be notified directly by the monitoring system itself, saving valuable response time. This paper aims to set up an infrastructure for monitoring patients in hospital ICUs. An architectural framework and related protocols to support communication between the various components of such a system are presented. The prototyped product was successfully demonstrated to industry representatives, in November 2005, at Villanova University, PA.

EmerLoc: Location-based services for emergency medical incidents

BACKGROUND

Recent developments in positioning systems and telecommunications have provided the technology needed for the development of location aware medical applications. We developed a system, named EmerLoc, which is based upon this technology and uses a set of sensors that are attached to the patient's body, a micro-computing unit which is responsible for processing the sensor readings and a central monitoring unit, which coordinates the data flow.

OBJECTIVE

To demonstrate that the proposed system is technically feasible and acceptable for the potential users.

METHOD

Transmission speed is assessed mostly by means of transmission of DICOM compliant images in various operational scenarios. The positioning functionality was established both outdoor using GPS and indoor using the UCLA Nibble system. User acceptability was assessed in a hospital setting by 15 physicians who filled in a questionnaire after having used the system in an experimental setting.

RESULTS

Transmission speeds ranged from 88kB/s for a IEEE 802.11 infrastructure to 2.5kB/s for a GSM/GPRS scenario. Positioning accuracy based on GPS was 5-10m. The physicians rated the technical aspects on average above 3 on a 5-point scale. Only the data presentation was assessed to be not satisfactory (2.81 on a 5-point scale).

CONCLUSION

The reported results prove the feasibility of the proposed architecture and its alignment with widely established practices and standards, while the reaction of potential users who evaluated the system is quite positive.

An internet-based telemonitoring system of multiphysiological parameters

The purpose of this research was to design and realize a real-time tele-monitoring system with multiphysiological parameters using the Internet. Both the Client/Server (C/S) mode and Peer-to-Peer (P2P) mode were used in the system's network communication. The C/S mode is used to upload, retrieve, and download physiological data. The P2P mode provides realtime tele-monitoring and video chatting between doctors and patients. Experiment results show that P2P technology could efficiently improve the transmission speed of the physiological parameters. This study demonstrates an effective method of remote monitoring of physiological parameters in real time.

Wearable medical devices for tele-home healthcare

The world's ageing population and prevalence of chronic diseases have lead to high demand for tele-home healthcare, in which vital-signs monitoring is essential. An overview of state-of-art wearable technologies for remote patient-monitoring is presented, followed by case studies on a cuffless blood pressure meter, ring-type heart rate monitor, and Bluetoothtrade mark-based ECG monitor. Aim of our project is to develop a tele-home healthcare system which utilizes wearable devices, wireless communication technologies, and multisensor data fusion methods. As an important part of this system, a cuffless BP meter has been developed and tested on 30 subjects in a total of 71 trials over a period of five months. Preliminary results show a mean error (ME) of 1.82 mmHg and standard deviation of error (SDE) of 7.62 mmHg in systolic pressure; while ME and SDE in diastolic pressure are 0.45 mmHg and 5.27 mmHg, respectively.

A TELE-EMERGENT SYSTEM FOR LONG-TERM ECG MONITORING OVER WIRELESS SENSOR NETWORK

This paper presents the design and implementation of a tele-emergent system to provide constant monitoring of cardiac patients. Our system is consisted of a user integration device attached to the patient, a wireless sensor network (WSN) and a medical gateway installed in the patient's home, and a server set up in the hospital. The user integration device includes Electrocardiogram (ECG) signal acquisition and processing circuit utilizing a "Modified So and Chan" QRS detection algorithm to discriminate the R signal wave and calculate RR intervals to subsequently detect abnormal Heart Rate Variability (HRV), and a Bluetooth transmission module to communicate with WSN. The WSN which is consisted of wireless sensor nodes with power-saving scheme is used to relay the ECG data to the medical gateway for ubiquitous monitoring at home. The medical gateway includes the heart disease symptom recognition system to further analyze the ECG data and recognize the symptoms of serious heart diseases, and a General Packet Radio Service (GPRS) module with Multimedia Messaging Service (MMS) to communicate with the server in the hospital. The server in the hospital can passively process the MMS messages from the medical gateway, and actively send commands to the medical gateway to acquire the needed ECG data from the patient. With our integrated system it is possible to provide real-time and long-term monitoring of physiological data for cardiac patients which is vital for the patients' medical care.

A wireless ECG system for continuous event recording and communication to a clinical alarm station

Development of new wearable biomedical sensors within a wireless infrastructure opens up possibilities for new telemedical applications leading to significant improvements in continuous monitoring, and thereby to better quality of patient care. In this paper we describe a new concept for a wireless electrocardiogram (ECG) system intended for continuous monitoring of ECG activity especially designed for arrhythmia diagnostic purposes. The patient is wearing an ECG sensor, "a smart electronic electrode", with wireless transmission of ECG signals to a dedicated hand held device (HHD). This device is monitoring the continuously recorded ECG signal, and can detect abnormal ECG activity using an automatic arrhythmia detector. Based on this, the device will transmit alarm conditions to a remote clinical alarm station (CAS). The system will act as a continuous event recorder, which can be used to follow up patients who have survived cardiac arrest, ventricular tachycardia or cardiac syncope but also for diagnostic purposes for patients with diffuse arrhythmia symptoms. This paper describes the principle design requirements for the new wireless ECG sensor and system design for the HHD in order to transfer detected alarms to the CAS.

RTWPMS: a real-time wireless physiological monitoring system

This paper demonstrates the design and implementation of a real-time wireless physiological monitoring system for nursing centers, whose function is to monitor online the physiological status of aged patients via wireless communication channel and wired local area network. The collected data, such as body temperature, blood pressure, and heart rate, can then be stored in the computer of a network management center to facilitate the medical staff in a nursing center to monitor in real time or analyze in batch mode the physiological changes of the patients under observation. Our proposed system is bidirectional, has low power consumption, is cost effective, is modular designed, has the capability of operating independently, and can be used to improve the service quality and reduce the workload of the staff in a nursing center.