Description
PurposeThe purpose of this Activity is to demonstrate your understanding of the concepts learned in this week’s readings/ educational videos. Action ItemsBased on your reading explain some telemedicine applications for healthcare delivery?Submission InstructionsComplete and submit this assignment according to your professor’s instruction
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Hindawi Publishing Corporation
International Journal of Telemedicine and Applications
Volume 2014, Article ID 380787, 11 pages
http://dx.doi.org/10.1155/2014/380787
Research Article
A Wireless Emergency Telemedicine System for
Patients Monitoring and Diagnosis
M. Abo-Zahhad, Sabah M. Ahmed, and O. Elnahas
Electrical and Electronic Engineering Department, Faculty of Engineering, Assiut University, Egypt
Correspondence should be addressed to M. Abo-Zahhad; [email protected]
Received 25 October 2013; Accepted 25 January 2014; Published 6 May 2014
Academic Editor: Sotiris A. Pavlopoulos
Copyright © 2014 M. Abo-Zahhad et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
1. Introduction
A healthcare system in the last decade was made possible
due to the recent advances in wireless and network technologies, linked with recent advances in nanotechnologies
and ubiquitous computing systems. The term telemedicine
refers to the utilization of telecommunication technology for
medical diagnosis, treatment, and patient care [1]. The aim of
telemedicine is to provide expert-based healthcare to understaffed remote sites through modern telecommunication
(wireless communications) and information technologies.
One of the benefits of telemedicine is cost savings, because
information is less expensive to transport than are people.
Advances in medical technologies have led to accelerated
growth of the elderly population in many countries, resulting
in an increasing requirement for home health monitoring to
ensure that elderly patients can lead independent lives [2].
Many physiological signals can be measured from individuals
in their living environments during daily activities and are
potentially applied to observe the deviations of health status
in the early phase or to alert paramedics automatically in
emergency cases [3]. Especially for remote monitoring of
physiological parameters, all the studies developed and currently used in this area can be categorized by several aspects:
type of sensors, type of data communication, monitoring
device, and signal processing/medical algorithms [4]. So
these aspects along with recent studies will be discussed in
this section. As shown in Figure 1 the main telemedicine
system components in recent years include biosignal sensors,
processing units, data communication networks, and medical
service center.
The biosignal sensors are responsible for acquiring the
physiological data (patient’s vital signs) and transmitting
it to the signal processing unit. Several studies are made
focusing only on designing these sensors to be tiny in
size [5], maintain patient mobility [6], and consume low
operating power to reduce battery size which can last for
longer durations [7]. A collection of wearable medical sensors
could communicate using personal area network or body
network [8], which can be even integrated into user’s clothes
[9]. At the next stage, sensor layer of every remote monitoring
system is typically connected to the processing device for
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International Journal of Telemedicine and Applications
Patient’s side
Cellular
network
HTTP
Biosignal sensors
Doctor
Processing unit
GPRS
Communication
unit
Internet
Doctor
TCP/IP
Home care unit
Data communication
networks
Medical
server
Management unit
Figure 1: Main components of telemedicine system.
signal acquisition, processing, analysis, and formatting data
to be sent to the communication layer. The processing unit
may evaluate patient status and trends in patient’s medical
condition. Processing unit can be PC [10], mobile phone
[11], or embedded system (microcontroller, DSP processor,
and FPGA) [12]. Many medical algorithms were developed
in recent telemedicine studies to help in patient diagnosis
[13] and early detection of cardiovascular diseases [14].
Among human vital signals, pulse assessment has long been
a research area of interest in the physiology field, because
the pulse reflects a person’s state of health [15]. Many
investigations have proposed monitoring systems that can
measure various biosignals and provide QRS detection and
arrhythmia classification [14], real-time ECG classification
algorithm [13], and heart rate variability measurement [14].
Also recent advances in wireless and network technologies
make it possible to develop a wireless telemedicine system which offers an effective means of bringing healthcare
services to patients. Telemedicine systems can be divided
into two modes of operations: real-time mode, in which
patient data are available at the server end immediately after
acquisition, and store-and-forward mode, which involves
accessing the data at a later time. In both modes, the vital
signs are transmitted via computer networks [16], cellular
networks [17], public telephone networks [18], or cable TV
networks [19] to the server. In these system models, an expert
is expected at places where he/she can use a PC to access the
server for analyzing the vital signs data, and the patient is
bounded at a fixed place like home or healthcare center where
a PC is equipped for transmitting these data. The use of wired
network connected PCs limits the degree of freedom of both
doctors and patients to move around.
To improve the mobility of the doctor, the global system
for mobile (GSM) communication mobile telephony network
was used for connecting the server [20]. In [21], Hung and
Zhang implemented a wireless application protocol (WAP)
based telemonitoring system. It utilized WAP devices as
mobile access terminals and allowed doctors to browse the
monitored data on WAP devices in store-and-forward mode
[22]. In such systems the improvement on the mobility of
the patient is much less, compared to the doctor. In many
previous telemedicine systems, the sensor unit consisted of
an ECG data acquisition circuit, an A/D converter, and
a storage unit. To provide a very limited mobility of the
patient, this unit was equipped with an indoor, wireless
transmitter for feeding the monitored data to a network
connected PC [18, 21]. A GSM modem was equipped with a
PC for real-time transmission of ECG data from a moving
ambulance vehicle in [23]. In [24], Rasid and Woodward
suggested a mobile telemonitoring system using a Bluetooth
enabled processor unit, which transmits the monitored data
to a Bluetooth mobile phone and subsequently via the
GSM/GPRS (general packet radio services) network to the
server. On the other hand, Engin et al. [25] used a mobile
phone to transmit the measured ECG signal in real-time
mode. In these designs [24, 25], the mobility of the patient
is improved. However, the analysis of ECG is not performed
in the place where the ECG is acquired; for example, the
ECG is analyzed at the server end. In fact, there is a loss
of efficiency in the use of the GSM/GPRS network because
normal ECGs are also transferred, which implies a high
cost. Lin et al. [26] developed a mobile patient monitoring
system that integrates PDA technology and wireless local
area network (WLAN) technology to transmit a patient’s
vital signs in real-time to a remote central management
unit. The system was based on a small-sized mobile ECG
recording device which sends measurement data wirelessly to
the mobile phone [27]. In the mobile phone, the received data
is analyzed and in cases of any abnormalities found among
parts of the measurement data, it will be sent to a server.
However, because of the limits of processing units within the
mobile phone, the overall performance was hardly operated
in an ideal condition [28]. Delay in the data transmission
might also disrupt the data analysis and measurement.
According to the discussed components of the telemedicine
system, all systems developed can be categorized by several
International Journal of Telemedicine and Applications
3
Table 1: Set of telemedicine studies along with aspects which each study concerns.
Reference
number
Biosignal
sensors
Communication technology
GSM/GPRS
Internet
√
Medical algorithm
[29]
ECG, BP, HR
TEMP.
√
[3]
HR, SPO2,
TEMP., RESP.
√
[4]
Weight, activity,
BP
√
√
[5]
BP, HR, TEMP.
√
√
[6]
ECG, HR,
SPO2,
TEMP., RESP.
√
[9]
ECG, BP, HR
TEMP., PPG
√
√
[14]
ECG
√
√
[13]
ECG
√
√
[15]
Pulse signal
√
√
[22]
ECG, HR,
SPO2,
TEMP., RESP.
√
[23]
ECG, BP, HR
TEMP.
√
√
√
aspects: type of sensors, type of connection between sensors,
monitoring/processing device, data communication technology, and signal processing algorithms. Table 1 summarizes
a set of telemedicine studies in the last decades along with
aspects which each study concern.
In this paper, we propose a wireless telemedicine system
which integrates sensor unit, processing unit, and communication unit in one chip bounded to patient’s body called
mobile-care unit. This will improve patient’s mobility and
will not affect active daily life during monitoring. To lower
the cost of using GPRS network, only abnormal readings are
transmitted so the proposed system operates in two modes,
store-and-forward mode and real-time mode. In store-andforward mode the care unit records and transmits patient’s
vital signs to the server through the internet. When an abnormal heartbeat that the doctor concerns is detected, the care
unit transmits it to the server via GPRS network in real-time.
The doctor at the server side could communicate with the
patient also by using SMS if necessary. The proposed system
also has a friendly web-based interface for medical staff to
observe immediate vital signs for remote treatment which
√
Comments
WSN, type of localization method for
patients and an energy efficient
transmission strategy, video streaming.
Implement a prototype of telemedicine
system based on wireless technology
using GSM and GPS.
Android application for monitoring and
using Bluetooth enabled sensors.
Design of sensors to reduce power
consumption using VLSI and FPGA.
Wearable belt; high quality and flexible
modules for signal conditioning are
designed and assembled together.
Small rang RF transmission, smart
wearable vest, deriving BP and HR from
ECG.
QRS detection algorithm, extraction of
heart rate variability, implemented in the
PDA and GPS.
A real-time ECG classification algorithm,
GPS, and a real-time R wave detection
algorithm.
Intelligent data analysis scheme to
diagnose abnormal pulses for exploring
potential chronic diseases.
Vital signals are acquired from the
monitor using the RS232 interface and
transmitted through the internet.
Commercial monitors are used for the
acquisition of biosignals and Huffman
algorithm for ECG signal compression,
GSM, GPRS, POTS, or satellite.
will give more mobility for medical staff. The remainder of
this paper is organized as follows. The system is described
in Section 2. The proposed system consists of a mobile-care
unit and a server. The hardware and software designs of the
mobile-care unit are described in Section 2.2. The system
has been implemented and tested. Finally, Section 3 contains
some discussions and conclusions.
2. System Design
This section describes in detail the system design based on
physiological sensor, signal processing, embedded system,
and wireless communication and World Wide Web technologies. Figure 2 illustrates the architecture of the proposed
system. Section 2.1 presents an overview of the system architecture. Section 2.2 describes the system components and the
detail of the system operation.
2.1. System Architecture. The aim of this study is to design
and implement a telemedicine system with intelligent data
analysis based on physiological sensors, embedded system,
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International Journal of Telemedicine and Applications
Central
database
Emergency service
GSM/GPRS
(real-time mode)
GPRS
Family member
Mobile-care
unit
Patient
GSM/GPRS
Medical personnel
Remote server
Internet
Internet
(Store-and-forward mode)
HTTP
HTTP Caregivernurse
Local monitoring
Physician
Mobile-care unit
Data communication networks
Remote
server
Management/monitoring
units
Figure 2: The architecture of the proposed system.
wireless communication, and World Wide Web for vital signs
monitoring, patient diagnosis, and home care. Architecture
of the proposed system is shown in Figure 2. It mainly
comprises the following parts.
(1) Mobile-care unit: it could be bound to patient’s body
and could acquire real-time or periodical vital signs
information without affecting their normal activities.
Then an intelligent data analysis scheme is applied
to identify abnormal pulses and transmits these data
to the remote server by wireless communication
through either internet in store-and-forward mode
for normal case or cellular networks in real-time
mode for abnormal case. The transmission of patient
data in real-time mode can also be operated manually.
Whenever the user feels uncomfortable, he can transfer his current vital signs to the management unit for
advice or a checkup. By this way, the cost for using
the GPRS network is lowered because only abnormal
signals are transmitted. For possible long-term storeand-forward mode, the raw data can be stored in the
extended secure digital flash memory contained in
the mobile-care unit.
(2) The remote server: it stores the received vital signs
in a human physiology database and displays the
physiology signals to the medical personnel through
application program for diagnosis. Also, it enables
remote access for caregivers and physicians to obtain
vital signs through web-based interface over internet
to monitor these data on their pervasive devices. After
examining the vital signs data, the doctor can send
a feedback MMS message to the user. The message
may contain medical advice and/or a list of control
commands to the mobile-care device for resending
the abnormal case’s vital signs data. Also remote
server may alarm family member in abnormal case
and call emergency service to transport patient to
nearest medical center.
(3) Pervasive devices: pervasive devices include laptop,
personal digital assistant (PDA), and mobile phone.
Through these terminal devices family members or
doctors can acquire abundant information about the
healthcare recipients anywhere and at any time.
2.2. System Components. This section details the system
components of the proposed emergency telemedicine system
for patient monitoring and diagnosis.
2.2.1. Mobile-Care Unit. In the proposed system the mobilecare unit was designed to be portable and lightweight which
means it is easy to carry and easy to use making patients
do nothing. The mobile-care unit consists mainly of three
modules. These are mainly vital-sign signals acquisition
module, data control and processing module (MCU), and
data communication module. Thus it can collect critical
biosignals, including three-lead ECG, HR, blood pressure,
and SpO2 which are vital signs. Also, it may evaluate patient
status and trends in patient’s medical condition and it may
generate emergency alert if the patient’s condition is critical.
Moreover, it should support wireless communication and
be compatible with global positioning information system
to locate the patient position for emergency help. Figure 3
International Journal of Telemedicine and Applications
ECG electrodes
SPO2 sensor
Temp. sensor
(Acquisition module)
E-health sensor
shield V 2.0
[Filtering, amplification]
5
Processing
module (MCU)
PIC18F458
GPRS
module
ADC, processing,
controlling and
storing
Ethernet
module
BP. sensor
Flash
memory
Power supply unit
Figure 3: Mobile-care unit.
ECG
electrode
INA 321EA
diff. amp.
HPF
0.5 HZ
LPF
100 HZ
Notch filter
50 HZ
Amplifier
Figure 4: Block diagram of ECG acquisition hardware.
illustrates a block diagram of mobile-care unit. Also mobilecare unit includes local data storage which is used for raw data
recording together with signals processing results.
(1) Vital-Sign Signals Acquisition Module. Vital-sign signals
acquisition module is responsible for collecting vital signs
and then sends it to processing module for ADC, processing,
and abnormal detection. E-health sensor shield V2.0 is
selected to work as vital-sign signals acquisition module.
This module can continuously acquire physiological signs like
ECG, SpO2, body temperature, and blood pressure as shown
in Figure 3. All of vital signs measurements will be noninvasive measurement. Noninvasive measurement of vital
signs certainly has an advantage over its invasive counterpart
due to the ease of use and lack of risks involved in such
measurements.
ECG Sensor. An ECG is a bioelectric signal which records the
heart’s electrical activity versus time. The electrocardiogram
is obtained by measuring electrical potential between two
points of the body using specific conditioning circuit. In the
proposed mobile-care unit ECG signals from the electrodes
are amplified with a gain of 300 and filtered with the cut-off
frequencies of 0.5 Hz in the high pass filter and 100 Hz in the
low pass filter.
The ECG signals are typically 1mV peak-to-peak; an
amplification of 300 is necessary to render this signal usable
for heart rate detection and realizing a clean morphological
reproduction. A differential amplifier with gain of 20 avoids
the noises overriding the ECG signals; this is achieved by
an instrumentation amplifier (INA321EA), CMRR of 100 dB,
and at the end an operational amplifier (Analog AD8625) is
used to amplify the signal with a gain of 15. The ECG signals
are restricted in bandwidth of 0.5–100 Hz using second order
Butterworth high pass and low pass filters after the first stages
of amplification. The power line interference in the ECG
signal is filtered by a 50 Hz notch filter, which is user selectable
to avoid loss of 50 Hz component of the ECG signals. Then the
ECG signal is fed to the analog input of processing unit for
digitizing and analysis. Figure 4 illustrates the block diagram
of ECG signal acquisition hardware.
Temperature Sensor. The temperature of a healthy person is
about 37∘ C; it may slightly or temporarily increase in hot
environment or in physical activity; in extreme effort, the
increase may be very high. It is of great medical importance
to measure body temperature. The reason is that a number
of diseases are accompanied by characteristic changes in
body temperature. Likewise, the course of certain diseases
can be monitored by measuring body temperature, and
the efficiency of a treatment initiated can be evaluated
by the physician. An industrial CMOS integrated-circuit
temperature sensor shown in Figure 5(a) was chosen and
connected to signal conditioning circuit shown in Figure 5(b)
to calibrate and amplify the signal before feeding it to
processing unit.
Blood Oxygenation Measurement (SpO2) and Heart Rate.
SpO2 or pulse oximetry is the measure of oxygen saturation in
the blood, which is related to the heart pulse when the blood
is pumped from the heart to other parts of the human body.
When the heart pumps and relaxes, there will be a differential
in absorption of light at a thin point of a human body.
Oxygenated hemoglobin absorbs more infrared light waves
and allows more red light waves to pass through. However,
deoxygenated (or reduced) hemoglobin absorbs more red
light waves and allows more infrared light waves to pass
through. This unique property of hemoglobin with respect
to red and infrared light wave allows oxygen saturation to be
detected noninvasively. Pulse oximetry is a simple yet reliable
method to measure oxygen saturation that otherwise would
have to be measured by invasive methods. Red (660 nm) and
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International Journal of Telemedicine and Applications
Temp.
sensor
(a)
Amplifier
gain 100
Calibration
circuit
To
processing
unit
(b)
Figure 5: (a) Temperature sensor. (b) Signal conditioning circuit.
Figure 6: SpO2/HR sensor.
Processor
core
SRAM
EEPROM
/flash
Timer
module
Digital
I/O
module
Serial
interface
module
Analog
module
Interrupt
controller
…
infrared (940 nm) LEDs were chosen and populated onto
a custom-made sensor shown in Figure 6. Besides oxygen
saturation in the blood the used sensor also provides heart
rate. The output of the SpO2/HR sensor is fed to processing
unit through acquisition module. Specifications of various
physiological parameters monitored in the proposed system
are listed in Table 2.
(2) Data Control and Processing Module. Data control and
processing module is the heart of the medical care unit. The
main function of this module can be divided into two parts: in
the first part the developed algorithm synchronizes, controls,
and maintains the accurate operation and communication of
all the other modules. In the second part the developed algorithm digitizes and processes the acquired vital-sign signals to
determine if their respective values are above the preset limit
or not. If any or all of these values are above their respective
critical values then triggering alarm is made. After that all
processed data is transmitted to communication layer. This
module mainly consists of a microcontroller which is chosen
to verify certain specifications. Microcontrol unit (MCU)
with powerful processing and control capability is needed
to adapt a large amount of data acquiring and processing.
Moreover, this module also possesses a high degree of system
integration as well as more extension interfaces. We select
8 bit PIC18F458 microcontroller as the MCU of medical
care unit. It has input-output circuitry and peripherals builtin, allowing it to interface more or less directly with realworld devices such as sensors. Modern microcontrollers often
need little external circuitry. Among the most accessible are
the PIC microcontrollers. A microcontroller already contains
all components which allow it to operate stand alone and
it has been designed in particular for monitoring and/or
control tasks. In consequence, in addition to the processor it
includes RAM, ROM, and EEPROM memory units, SPI, I2C,
CAN, ADC, and UASRT interface controllers, one or more
timers, an interrupt controller, and general purpose I/O pins.
Figure 7 shows the architecture of the MCU.
Figure 7: Architecture of microcontroller.
We can summarize the main functions of MCU in the
proposed system as follows.
(1) It receives and digitizes the signals acquired from vital
sign sensors.
(2) It controls the operation of all connected modules as
shown in Figure 8.
(3) It processes the received signals using different sorts
of processing techniques and algorithms.
(4) It sets up a connection with the remote server and
transmits to it the analysis results and raw data using
communication techniques.
(5) It stores analysis results and raw data to flash memory.
(3) Software Components of the Processing Unit. The MCU
controls and coordinates all activities of mobile-care unit.
Figure 9 shows the workflow about the mobile-care unit.
Software has been written in C language to simulate MCU
and its components. It is based on the following concepts.
(1) Sensor and module initialization component: it is in
charge of starting, initializing, and configuring the
medical care unit.
(2) Vital signs perception component: it acquires the
values of vital signs from sensor nodes.
(3) Vital signs processing component: it realizes data
conversion and processing and carries out patient
diagnosis by determining the health status of patient.
(4) Information transmission component: data exchange
between mobile-care unit and server is realized with
the help of this component.
International Journal of Telemedicine and Applications
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Table 2: Specification of various physiological parameters monitored.
Physiological parameter
ECG
Heart rate (HR)
Body temperature
Blood pressure
Blood oxygenation (SpO2)
Respiratory rate
Specifications
Frequency: 0.5 HZ–100 HZ
Amplitude: 0.25–100 mv
40–220 beats per minute
32∘ C–40∘ C
Systolic: 50–300 mmHg
Diastolic: 40–140 mmHg
Measurement range: 70–100%
2–50 breath/min.
Typical values for average healthy person
R-WAVE amplitude: >4.5 mv
QRS complex: (0.04–0.12) msec
60–100 beats/minute
About 37.5∘ C
Systolic: less than 120 mmHg
Diastolic: less than 80 mmHg
Around 94% to 99%
Adults: 12–24 breaths per minute
Vital signs acquisition circuit
GSM/GPRS module
Flash memory
MCU
(PIC18f458)
Ethernet module
LCD/keypad module
Figure 8: Functions of MCU.
(5) Information receiving component: it helps the node
to receive the controlling or inquiring requests from
the server.
(6) Exception notification component: when the abnormal sensing information appears, it sends a message
to the server immediately and sends out the alarm as
soon as possible.
the purpose of receiving, storing, and distributing the vital
sign data from patients. The server is composed of presentation tier, web tier, and database tier. A multitier architecture
allows for separation of concerns where any tier in the system
can be expanded and updated with minimal or no effect on
the client tiers. The following subsections discuss the three
tiers further.
(4) Data Communication Module. Data communication module helps the medical staff to get patient’s physiological data
by connecting medical care unit to other networks such as
cellular network or internet. It is responsible for uploading
the received vital signs data to the remote care server
through cellular network to carry out the patient‘s health
condition monitoring and diagnosis. This module operates
in two modes: store-and-forward mode in which mobilecare device records patient’s vital signs continuously up to
specified period and transmits it to the remote server and
real-time mode which operates when an abnormal heartbeat
is detected. Mobile-care unit transmits all vital signs to the
remote server via GSM/GPRS network in real-time. In the
proposed system, medical care unit can send data through
internet network either by UDP or TCP protocols using
ENC28J60 Ethernet module shown in Figure 10(a). For realtime connection in emergency cases vital signs are transmitted through GSM/GPRS networks using sim900 GSM/GPRS
module shown in Figure 10(b). The GSM/GPRS module
used operates at Quad-Band 850/900/1800/1900 MHz and is
controlled via AT commands.
(1) Presentation Tier. The presentation tier allows the authorized user to interact with the received patient’s data through
application program developed using C# language. The interface design provides most of the general as well as functional
requirements as follows.
2.2.2. Remote Server Unit. In the application of telemedicine,
the medical information usually needs to be distributed
among medical doctors and display, archival, and analysis
devices. Therefore, the remote server unit is developed with
(viii) It shows notations (patient experience) while taking
measurements.
(i) Access constraints are applied all the time based on
the authorized user registered in the database.
(ii) It includes lists of patients and personal information
about patients.
(iii) It displays patients’ vital signals and sets thresholds for
each measurable parameter.
(iv) It alerts healthcare providers in abnormal cases.
(v) It adds new patient, new consultation, and drug
prescription.
(vi) It shows past medical records for all patients including
diseases, past surgeries, clinical findings, past medication, allergies, and images.
(vii) It provides search for all registered patients by
patient’s ID or patient’s name.
(ix) It sends messages including instructions for patients
and drug prescription.
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International Journal of Telemedicine and Applications
(i) store, retrieve, and update patient’s record including
his/her medical personnel’s contact information and
other details;
Start
Yes
(ii) store and retrieve the received physiological sensor
data transmitted by medical care unit;
Request to send?
No
No
(iii) store, retrieve, and update patient’s consultations and
drug prescriptions;
Manual
operation?
(iv) store and retrieve patient’s notation during sessions;
(v) store, retrieve, and update registered doctors, physicians, and nurses;
Yes
Sensors initialization
(vi) store, retrieve, and update the ECG data, record time,
location of the R wave, and estimated ECG beat type.
Vital signs processing
Figure 16 shows screen shot for how to search.
Is patient status
normal?
Yes
Setting up connection
through internet
Start sending raw
data
No
Setting up connection
through GPRS
Start sending raw
data
Alarming
Figure 9: Work flow about mobile-care unit.
(x) Sensor data will be automatically reloaded at predefined time intervals to keep the view updated.
Screen shots of the developed software are shown in
Figures 11, 12 and 13.
(2) Web Tier. Web tier allows different users such as physicians, doctors, and medical center to interact with the server
through a web interface. Remote web user will have realtime and continuous access to patients’ vital signs through the
internet. The web user interfaces with the web components
using HTTP protocol over TCP/IP connection. The information and content are presented to the user using an internet
browser through webpage designed using Microsoft visual
studio 2010. The designed webpage provides the most general
functions of developed application in the presentation tier
discussed previously. Screen shots of the designed webpage
are shown in Figures 14 and 15.
(3) Database Tier. The database tier is responsible for storage,
retrieval, update, and integrity of the data to and from the
presentation and web tiers. The most common way to access
the database is by using drivers that allow accessing a relational database management (RDBMS) to query or update
the data records. The driver used in the implementation of
the proposed system is JDBC drivers and the database is
deployed on a SQL database server. The database tier provides
the ability to do the following:
2.2.3. Monitoring Units. Web tier in the remote server is
designed to allow remote user to acquire abundant information about the healthcare recipients anywhere and at any
time using pervasive devices such as laptop, PDA, and mobile
phone. Finally we can say that the proposed system can
operate in the following three situations.
(1) Time-based connection: all data needed by the
remote caregivers or specialists should be uploaded.
Data compression is essential to limit the upload
time. In this situation the remote caregiver should
determine time schedule for uploading all patient
data to remote server. The time schedule is stored in
the mobile-care unit so it will upload data according
to this time schedule.
(2) Emergency connection: to lower the cost of using
GSM/GPRS network we develop algorithm which
detects abnormal heartbeats. So during sensor monitoring, if the mobile-care unit detects an abnormal
condition it sends the collected data to the remote
server in order to receive clinical assessment and
treatment planning.
(3) (Event awareness) connection on demand: the
mobile-care unit uploads the amount of data
requested by the remote caregivers or specialists to
monitor the health status of the patient.
3. Conclusion and Future Scope
This paper proposes the design and implementation of a
wireless telemedicine system, in which all physiological vital
signs are transmitted to remote medical server through both
cellular networks in emergency case and internet in normal
case for long-term monitoring. By this, the cost of using
GSM/GPRS network is reduced as only abnormal cases will
be tran
