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Telemedicine Systems


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 ... – PowerPoint PPT presentation

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Title: Telemedicine Systems

Telemedicine Systems
  • Rohitash Gupta
  • 2007A8TS442U

What are Telemedicine Systems?
  • Replacement for older versions of home care
  • Integration of communication and medicinal
  • Solution to the difficulties of transport for the
    elderly and too sick
  • Bypasses physical hospital restrictions
  • Top 3 Current Uses Radiology, Dermatology,

  • 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

Pictorial Representation of a Telemedicine System
The ECG (Electrocardiogram)
  • aka Heart Rate Monitor
  • Measures multiple patient vitals
  • Heart Rate, Blood Pressure, Respiration,
    Temperature and SPO2 levels
  • With this information, diagnosis is easily made

How does an ECG work?
  • 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

Elements of the ECG
Elements of the ECG (contd)
  • 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

Interpreting the ECG
  • 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

Common output of an ECG
  • 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

ECG Process without Telecardiology
ECG with Telecardiology
Goldman Risk Score
Building a Telemedicine System
  • 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

Selection of size of system
  • To keep it simple, I decided to go for a
    small-scale 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

Site Assessment
  • The patient lives in a fairly wealthy
  • 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

Cost of Equipment
  • 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

Ensuring Basic Implementation
  • 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

Equipment Specifics
  • 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

Equipment Specifics (contd)
  • 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.

Basic information flow
Pictorial representation of the System
Internet transmission from the mobile phone to
the network setup at the health care center to
receive and store the information output from the
Patient (Client Side)
Mobile receiver
Ge MAC 5500 receives input and sends it through
wireless internet to a mobile phone
Doctor receives and processes the information,
then sends back the diagnosis
9 Mats K. E. B. Walling MD, MSc t, and Samson
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