Rohitash Gupta 2007A8TS442U

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

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

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

aka Heart Rate Monitor Measures multiple patient vitals Heart Rate, Blood Pressure, Respiration, Temperature and SPO2 levels With this information, diagnosis is easily made

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

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

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 its most common functions

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 MIs or misdiagnoses

It is a monumental task that requires a whole host 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

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 patients 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

The patient lives in a fairly wealthy neighborhood The clients 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

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

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 cant 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

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

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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