The Study of Portable Remote Multi-life-parameter
Contents
1. 4 5 6 7 8 bum Kear el Fig 2 The experimental environment of the system az rt ig a EE FP MAME TE FEGE fer 79 0 00 00 0 00 00 000 000 b HL SG Se 78 ai Wi a ln jv A h A i i WWT ea dha d r dn S rT it l li L 4 ne fn LH mal ep Fig 4 Display on PC D G Guo et al A wearable BSN based ECG recording system using micromachined electrode for continuous arrhythmia monitoring in Medical Devices and Biosensors 2008 ISSS MDBS 2008 5th International Summer School and Symposium on 2008 pp 41 44 Yoo S K K M Kim et al 2004 Design of Multimedia Telemedicine System for Inter hospital Consultation Engineering in Medicine and Biology Society 2004 IEMBS 04 26th Annual International Conference of the IEEE Jing B H Bingyi et al 1997 A communication server for telemedicine applications Information Technology in Biomedicine IEEE Transactions on 1 3 205 209 L Jin et al A Multimedia Telemedicine System in Biomedical Engineering and Computer Science ICBECS 2010 International Conference on 2010 pp 1 3 Analog Devices Inc AD620 Instrumentation Amplifier E manual M Analog Devices Inc 1999 1 14 Fig 3 Test result of terminal OERSET LERSET WAER fi mmHg 124 98 si 7 oY ORR Ha eee 78 aneti o Se be Wi wace mse vE 38 2 sw ev i mmol L sxe 5 6 M4 0 Botka 152 Fig 5 Display on the server2. 9 JIAPU PAN and WILLIS J TOMPKINS A Real Time QRS Detection 133 10 11 12 13 14 Algorithm IEEE Transactions On Biomedical Engineering VOL BME 32 NO 3 MARCH 1985 Jianxin Qi Zhengzhong Bian QiangYang PC based real time automatic ECG analysis system J Beijing Biomedical Engineering 1997 3 133 136 SiRF SiRF star I User Manual M SiRF Technology Inc 2005 1 3 D Ziadlou et al Telecommunication Methods for Implementation of Telemedicine Systems in Crisis in Broadband Communications Information Technology amp Biomedical Applications 2008 Third International Conference on 2008 pp 268 273 SIEMENS MC55 56 Hardware Interface Description Version 2 06 manual M SIEMENS 2004 73 78 Youlong Luo Yuanyi Tang The RTC client API programming J Journal of Xi an Institute of Posts and Telecommunications 2003 8 1 37 40
3. parameters can be measured via external monitor modules which are optional and connected to the terminal through UART port The terminal is tested successfully on Omron Upper Arm Blood Pressure Monitor HEM 752 deviationt 4mmHg OneTouch Glucometer measure range 0 33 3mmol L and deviation 0 lmmol L and the fetal heart sound monitor applied to Doppler ultrasound and DSP technology measure range 60 240 bpm developed by our lab After filtered amplified and AD converted 8 the signals are stored in the mass storage device on board flash or SD TF card to be uploaded The calculated results such as heart rate and body temperature are stored in database to be analyzed In addition the authority of data operation makes sure the data safety and privacy In data processing part the terminal analyzes the data by parameters such as P R interval and body temperature The instantaneous and average heart rate P R and Q T interval are calculated by ways of threshold and slope to detect QRS complex 9 10 Meanwhile the terminal reads the blood pressure blood sugar and etc through UART Comparing the parameters with those in normal range it estimates whether the user is healthy or not The results are displayed on the TFT LCD screen to users Considering the system s load capacity the terminal supports static and dynamic display solutions The static one lets the user observe specified period physiological data and the dynamic one always d
4. small size low cost high reliability and real time processing Keywords Telemedicine physiological parameters GPRS monitoring terminal B ecause of the time and cost patients usually will not keep staying in hospital until full recovery Instead they typically choose to leave hospital first and take periodical subsequent visits Therefore it becomes hard to track chronic disease and rehabilitation after surgery In recent years related technologies have developed rapidly making portable multi life parameter monitor a desirable research topic 1 Wirelessly powered patch type healthcare sensor IC 2 made by P FCB planar fashionable circuit board technology and micro machined ECG electrode 3 4 based on MEMS Micro Electro Mechanical Systems technology have been developed successfully March 2004 the United States CardiNet company successfully developed ECG remote monitoring technology based on CDMA digital mobile phones May 2004 an ECG remote monitoring system with GPS was developed in some regions of Spain June 10th 2005 the heart remote monitoring center in Qilu Hospital of Shandong University established Asia s first GPRS wireless communication network remote monitoring institutions cardiac remote monitoring system May 2006 China GPS I INTRODUCTION 130 Mindray Company developed the PM 8000 Portable Multi life parameter monitor which monitors the user s ECG blood pressure and oxygen parameters December 20
5. 07 China Laikang Company successfully developed the world s first PHA Personal Health Assistant ECG remote monitor However monitors mentioned above are either single parameter or lack of some functions such as GPS Due to the simultaneous requirements of high performance and low cost full featured products are not seen in widely use or even still in research or trial This paper presents a portable physiological parameter monitoring system The system is suitable for the general consumption level and network construction situation in most areas of China The whole medical monitoring network is illustrated in Fig 1 It supports several kinds of communication application models 5 6 as listed in Tab 1 The terminal collects the user s ECG body temperature blood pressure and other key life parameters with self diagnosis and alarm functions If abnormal parameters are detected anomaly data alarm signal and GPS data will be transmitted to the monitoring center automatically and immediately The terminal can be connected to PC via USB transferring data by cable networks Moreover the system is mainly designed for wireless use in open air using GPRS General Packet Radio Service GPRS method as the primary means of data communication Il TERMINAL STRUCTURE The portable multi life parameter monitoring terminal adopts ARM9 processor S3C2410A rich in on chip resources such as 8 channels AD converter 3 channels UART USB controller an
6. 2011 IEEE 13th International Conference on e Health Networking Applications and Services The Study of Portable Remote Multi life parameter Monitoring Network Qinwu Zhou Ziwei Lin Junhong Chen Hongyan Fu School of Life Science and Technology X1 an Jiaotong University XJTU Xian P R China 710049 Abstract With the development of modern signal processing and computer network technology it brings new challenges to remote health care structure This paper discusses a prototype which realizes the functions of physiological signal collection and calculation GPS global positioning and data transmission through GPRS The new type of portable multi life parameter physiologic monitoring terminal is based on embedded design method It consists of physiological signal collection unit GPS unit data storage unit data analysis unit LCD 320 240 display unit and data communication unit The physiological signal collection unit includes ECG temperature blood pressure and blood sugar part The server system deals with physiological database user information interacting of physician patient with audio and video computer automatic diagnosis wired or GPRS data transmission We expect to solve the shortcoming of poor operability large volume and high price of the traditional biological monitoring devices Multi life parameter of the patients can be monitored remotely and wirelessly with the advantages of good operability strong scalability
7. and many other functionalities for clients It also realizes measurements of ECG blood pressure blood glucose and other physiological parameters as well as real time location of users The prototype is flexible and has great extendibility To continue with the project we will make more efforts to strengthen data security of tele medical system For example data encryption or distributed system which separates data and control may be used We will also explore compatible problems between data information and existing medical standard With the developing medical technology and rapidly sharing information in the future it s an important area how to make telemedicine system adapt to the needs of different tele medical modes and to provide more convenient more economical and more comprehensive services to doctors and patients The prototype introduced in this paper is an innovation and attempt in this area REFERENCES 1 B A Walker et al Low cost ECG monitor for developing countries in Intelligent Sensors Sensor Networks and Information Processing ISSNIP 2009 5th International Conference on 2009 pp 195 199 L Yan et al A 0 5 mu V rms 12 mu W Wirelessly Powered Patch Type Healthcare Sensor for Wearable Body Sensor Network Ieee Journal of Solid State Circuits vol 45 pp 2356 2365 Nov 2010 L M Yu et al A MEMS based bioelectrode for ECG measurement in Sensors 2008 IEEE 2008 pp 1068 1071 2 3
8. d SD card controller It consists of five parts 7 the physiological data collection management data processing and display communication and the GPS positioning part The terminal takes ECG and body temperature as basic monitoring parameters ECG is acquired by high quality and cost effective Ag AgCl electrode I lead II lead V lead ECG filter and collection circuit are designed using standard five lead cable and formed by Wilson resistor network For monitoring use 5 lead is enough Too many leads will increase the number of ECG data system cost and communication expense The parameters of the ECG collection circuit are listed in Tab 2 The body temperature is detected by ET series NTC resistor with measuring range of TABLE I SEVER COMMUNICATION MODEL Communication Application Meth method environment emhods after physiological signals are acquired by the terminal the terminal is connected to the Wireless outdoors server in hospital and data are transmitted through GPRS network physiological signals are acquired at home or in at home in n community clinics the community or f Cable d terminals are connected to the epartments of l the hospital server in hospitals through l cables which connect PCs into internet Data communicate among regional between eae hospitals in different regions interconnection hospitals through Internet 18 45 C and accuracy of 0 1 C Blood pressure blood sugar and other
9. e multiple connection simultaneously from clients The main thread is responsible for monitoring It monitors if the users data are transmitted then creates a new communication thread which carry out data transfer reliably with users by data communication channels In order to transmit data between the server and the client we have designed a set of suitable communication protocols The communication protocols can be divided into following parts 1 Handshake signal It s used for the client request connection to the server with user s ID packaged in it The server receives handshake signal and analyzes the data packet If the ID is confirmed the server establishes an interface channel with the user The client receives server s confirmation then it starts to send physiological data packet The large amount of ECG data can be divided into many data packets and transmitted in turn Different types of data packets can be distinguished in different identities with packet order transmission time and other information packed in it The server receives data packet analyzes its content and carries on CRC verification Then the client is noticed whether to continue with the next packet or to re send the current data again based on the verification result After finishing the data transmission the client sends conclusion signal to the server The server confirms type of physiological data and feeds back computer automatic diagnosis resul
10. isplays the latest sampling data and result Once the terminal detects abnormal physiological parameters it will give an alarm The user s present latitude and longitude coordinates will be sent to the server right away and displayed on the terminal in the way positioning software OziExplore uses The location information is read from GPS module 11 through UART Then the longitude and latitude are recognized by GPRMC or GPGGA sentences After picking three points not overlapped on the map as basic 131 TABLE II ECG COLLECTION CIRCUIT PERFORMANCE Item Performance measure range 2 5mV CMRR gt 80dB sample rate 300Hz band pass frequency 0 05 100Hz trap frequency 50Hz input impedance gt 100MQ AD resolution 10 bit Biosignal M PC wire O user y GPS satellite Fig 1 The medical monitoring network points any location on the map will be confirmed by calculating the latitude and longitude of them The test of the GPS part shows the deviation of the GPS system is less than 50 meters limited by the precision of the map Thus the transmitted GPS information will save a lot of valuable time for the rescue The maps on the monitor are configurable which can be updated by users according to his living area Telemedicine communication includes wired telephone network cable internet network WLAN satellite communications RF communications infrared comm
11. nt messaging and audio and video communication The control layer mainly contains sending and receiving control which supports connection via GPRS and cable networks data control which operates database directly including data storage inquiry modification automatic diagnosis and account management and then display control which is responsible for reacting and feeds back commands The interface layer is an interactive platform between software system and users to clearly and accurately describes the ECG I II V waveform physiological data patient s basic information audio and video communication and instant messages with patients connected The database structure design of the server utilizes VC MS SQL Server developing environment MS ODBC specification and standard database APIs The procedure operates database which maintains 5 entries to search add edit delete and so on With Microsoft COM module RTC APIs software system can create PC to PC PC to terminal calls instant messaging application and draws board sharing through Internet RTC supports many kinds of decoders based on the communication ability and bandwidth including G711 G722 1 G723 GSM DVI4 and SIREN Video decoder contains H 263 and H 261 14 In this paper H 263 is selected with bit rate of 6Hbps 125Kbps and OCIF and CIF media forms supported The video capture mode is MSH263 This paper utilizes multi thread technology to meet the needs of handl
12. ts or notices the client to stop communication directly 2 3 4 132 IV RESULT AND DISCUSSION The experimental environment of the whole system is shown in Fig 2 In order to check whether the terminal works well and server network design is correct patient simulator MiniSim 1000 V1 3r2 designed by Neteck Corp is connected with 5 lead cable to the terminal Also external module like blood pressure module blood sugar and fetal heart sound monitor are connected The test result is shown in Fig 3 The calculation of heart rate is correct and the deviation is less than 2 bpm Because the power of terminal is supplied by AC adaptor the result also shows the influence of the power frequency Fig 4 shows the display on PC and the ECG waves are I II V lead in turn Digital FIR filter is designed for the PC program so the baseline drift problem and power frequency interference problem are well solved and the QRS complex T wave P wave are legible Fig 5 shows the display on the server The physiological signal parameters are shown on the left the display settings on the right and ECG waves in the central V CONCLUSION This paper proposes and realizes a telemedicine prototype which consists of different tele medical modes interaction of many kinds of signals variety of transmission methods data storage and information management It provides centralized management of data information interaction diagnostic alarm
13. unications mobile network GSM CDMA and etc 12 Considering cost and portability the data are transmitted by two ways In the first way the terminal is connected to PC on which physiological data are displayed Then to the server by the cable which connects PC to the Internet In the second way the data are transmitted through GPRS into the Internet by operating GPRS module 13 through UART using AT commands CRC checksum is used to ensure the data exactness The data from terminal to server includes user ID data type collection time data size data and CRC code In order to improve the real time performance and stability RTOS uC OS II is ported on the terminal The RTOS is in charge of task management The task priorities are differentiated according to interrupt relevance urgency and requirements Task priority descends from data receiving acquisition sending device input data processing to display task File system wC FS is also ported to manage mass storage device with FAT file supported II THE SERVER SYSTEM ARCHITECTURE The operating system of central server is Windows XP The server software s system architecture is divided into 3 layers The data layer has two parts One is database which takes charge of the storage and management of the patient s medical records physiological data user accounts as well as linkage records between patients and server the other is data stream which is to provide point to point insta
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