SMART been built on concepts of user-friendly, efficient

SMART VIRTUAL

PATIENT MONITORING SYSTEM

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     VENKATESH M #1 , VISHUVAPANDI P
*2

#* DEPARTMENT
OF INFORMATION TECHNOLOGY

#* SRI
SAIRAM ENGINEERING COLLEGE, CHENNAI, TAMILNADU, INDIA

#1 [email protected],
*2 [email protected]

Abstract
– The virtual patient monitoring system
uses mobile computing, wireless technologies and web interfaces for periodic
measurement and analysis of biosignals of a patient. This project has been
built on concepts of user-friendly, efficient for both patients and doctors. In
this paper a comparative study over the mobile patient monitoring system is
done on basis of real time applications.This paper aims at the greatest to
strengthen the patient-doctor relationship and also help people in remote areas
who are in need of specialized doctor. This paperwork implements technologies
such as telemedicine, wireless communications, mobile health, web interfacing
etc. This simply connects doctor and patients, and helps to rescue the patient
under critical situation. Computer professionals are expected to benefit by
gaining an understanding of latest developments in modern and emerging
application are of medical sciences

Keywords : Mobile patient monitoring system, Remote
patient monitoring system, M-Health, E-Health, Telemedicine, Mobile
Application, Web Interfacing, Smart Wearables

 

I.         
INTRODUCTION

Forecasting
today’s scenario, a patient has to carry all his medical reports to doctors
unknowing of the doctor’s specialization fields. This may lead to wrong
treatments. This may also be caused due to uncertified doctors. As important as
relation between patient and health care professionals, a doctor or nurse can’t
be in the room with each patient all time even in fully staffed hospital.
Modern technologies have enabled the calculating electrical activity of the
heart, respiration rate, blood pressure, body temperature etc.

”E-health
is an emerging field in the intersection of medical informatics, public health
and business, referring to health services and information delivered or
enhanced through the Internet and related technologies. In a broader sense, the
term characterizes not only a

technical
development, but also a state-of-mind, a way of thinking, an attitude, and a
commitment for networked, global thinking, to improve health care locally,
regionally, and worldwide by using information and communication technology.”7

 

From the definitions stated on e-health, it includes
aspects of telemedicine and not

 

actually
involve remoteness. In an article ‘E-health prospects’, Joseph Tan expresses
that because of transition and transformation of traditional ICT applications
to wireless platform resulted in emergence of Mobile Health (m-health) and is
considered natural development.6

 

M-health
is the application of mobile computing, wireless communications and network
technologies to deliver or enhance diverse healthcare services and functions in
which the patient has a freedom to be mobile, perhaps within a limited area. 8 Typical
m-Health applications are automated patient alerts, e-prescriptions and mobile
patient monitoring and tracking.5

 

Mobile
patient monitoring is the continuous or periodic measurement and analysis of a
mobile patient’s biosignals from a distance by employing mobile computing,
wireless communications and networking technologies.4

 

WHO has stated that the heart disease rate might
increase up to 23.3% worldwide by year 2030.13 Moreover diseases such as chronic diseases and
abnormalities such as arrhythmia, hypotension, hypertension, hypothermia etc.
require continuous and long term monitoring to control threats

II.      
LITERATURE SURVEY

A
very large number of Mobile patient monitoring systems have been proposed. From
those proposals, few systems’ architecture is explained on the basis of
technologies used such as wireless communication technologies, practical
trials, incorporating modern wearable technologies. Based on selected
conditions proposed project works are

1)      
Personalized Health Monitoring (PHM) system
developed by the University of Technology Sydney2

2)       
MobiHealth
patient monitoring system developed as a part of the MobiHealth project
(supported by Commission of the European Union in the frame of the 5th research
Framework under project number IST-2001-36006) and subsequent projects

3)     
 Cloud-based Mobile Application  such as Vivify, Independa caregiver etc

 

1)       
Personalized
Health Monitoring System (PHM)

            The
Personal Health Monitor (PHM) system 2 is designed for patients who have a suspected cardiovascular
disease and need to be monitored around the clock. The PHM system proposes use
of off-the-shelf sensor systems which incorporate a built-in sensor front end.
This approach allows a PHM system user to use their own mobile phone running
Microsoft Windows and to buy or rent the required sensors. The patient
downloads the PHM application onto the mobile phone and uses it like any other
mobile application.

 

 The architecture of PHM
system is shown in Fig.1. Table 1 describes the PHM system according to our comparison framework. According
to the article 14 the PHM trial demonstrated that the system is easy to use and, in
the majority of cases, biosignals received by the cardiologists were of
sufficient quality to make a proper assessment. Another feature of the PHM
system is that the healthcare professional can select one or more sensors to be
used for a particular patient for providing personalized monitoring and
treatment. The PHM trials highlighted the need for personalized feedback.
Findings were, for example, that some patients did

not like to interact much with the application as they found it
stressful. Some elderly patients living alone reported that they would have
liked to have audio

Table
1 Features of PHM mobile monitoring System 2

 

remainders and warnings. Further feasibility study of the use of PHM
system for a noninvasive Cardiac Rhythm Management (CRM) System is reported in 15. Accordingly, to
date, this system has been applied on 70 low risk heart patients and the
preliminary results show the commercial potential of this system for
identifying and diagnosing arrhythmia abnormalities. The results of this study 15 are used to identify
potential applications of the PHM system in the following areas: cardiac
rehabilitation, community healthcare, monitoring of lifestyle changes and
athletic performance.

 

2)       
MH
Mobile Patient Monitoring System

The
main motivation behind the development of the MobiHealth (MH) system, first
developed during the MobiHealth project, was that of providing ubiquitous
medical care by means of mobile monitoring using Body Area Networks and
wireless technology. MobiHealth was the first project to apply Body Area
Network Technology for patient monitoring applications, hence was the
originator of the concept of Health BAN 3,16,17.
The system was further developed in various European and Dutch projects 17,18. Instead
of focusing on patients with one particular health condition, MH focused on
developing a generic BAN which can be specialized for any particular type of
telemonitoring or teletreatment application by integrating a specific set of
sensors and other devices together with the appropriate application
functionality. During the MobiHealth project the generic BAN was specialized
for different conditions including high-risk pregnancies, trauma, cardio-vascular
disease and COPD 19. The original MH BAN was implemented using both wired (front-end
supported) sensors from TMSI and wireless (self-supporting) sensors from EISlab
20. In both cases Bluetooth was used for intra-BAN communication 17. The
architecture of the MH system is shown in Fig. 2. The
MobiHealth project trials reported positive experience working with the
healthcare organizations and clinicians. However, in the initial version of MH
system, technical failures (such as system instability), sub-optimal interface
design and a difficult (re)start sequence caused irritation and confusion to
users. Preliminary trials showed the feasibility of using the system, however a
number of problems were encountered. For example, ambulatory patient monitoring
was more successful for some biosignals than others, because in some cases
measurements were severely disrupted by movement artefacts 16.
The limited

         
                  Fig 1. Architecture of PHM mobile
patient monitoring system2

bandwidth provided by 2.5G wireless wide area network (WWAN) technologies
(GPRS) was not sufficient for the applications which required monitoring many simultaneous
signals per user. Where 3G (UMTS) was available the MobiHealth trials did not
suffer from this restriction. A later project, AWARENESS 21,
implemented an epilepsy seizure detection application where, when available
bandwidth is low, an analysis algorithm runs locally on the BAN and only alarms
are sent to the health professional. However, if sufficient bandwidth is
available, the biosignals are transmitted to

the back-end for processing by a more sophisticated detection
algorithm 22. Results from the Myotel project 23 indicated
that continuous local biofeedback
enabled chronic pain patients to adapt their behaviour rapidly and results in
long lasting treatment effects. Adding a teletreatment dimension with feedback
from the remote therapist was shown to further improve clinical outcomes
related to pain and disability

 

                            Fig 2. Architecture of MH mobile
patient monitor system4

3)       
Cloud-Based
Mobile Application (Vivify)

Vivify10  provides cloud-based applications that
patients can usd from home to access their care plan and keep track of their
vital signs. The data is transmitted to physicians, who can access it on mobile
devices, computers and Internet-connected television. The software includes
medical coaching, customized care plans, video conferencing with physicians and
educational videos. The platform is interoperable with EMRs, PHRs and HIEs. The
challenge Vivify and providers will have with many of these patient-data tools
is getting people to use them consistently.9

Wearable Technology:

            The main
working behind the whole concept is the accuracy in measuring the heart-rate in
real time monitoring system. Heart rate or pulse is simply rythmic expansion of
arteries due to flow of blood. Hardware issues such as battery problems may
disrupt the whole mechanism.So it is necessary to select efficient
technological models such as ZaphyrBT
12.  Researches from
the National University of Singapore have created a
replacement for batteries all together would be an electrode used to harvest the
current caused by friction on the skin and clothes.  The result is enough
power, from a finger tap on skin, to power 12 LED bulbs. The future could mean
there are no need for batteries in wearables or smart clothes.  So how
does it work? An electrode is used to harvest the current, so a 50nm-thick gold
film is used. The gold film sits below a silicone rubber layer composed of
thousands of tiny pillars that help create more surface area for skin contact,
which creates more friction. Since the skin is a one of the triboelectric
layers it means the device can be small.  Scientists have already shown
off a wearable powered by the device.11

 

                     

                              Fig 3. Sample Screenshot of Vivify
Mobile Application10

 

 

III.           
PROPOSED WORK

 

The proposed project
comes up with idea of smart virtual patient monitoring system any time anywhere.
This includes creating unique accounts for individuals and doctors, wherein
each individual’s medical reports are uploaded which are accessible by the
individual and doctor. This system connects with a fit bit in individual wrist.
This fit bits or any form of device can be used to calculate and transmit
details regarding the biosignals such as electrical activity of heart, blood
pressure, blood temperature etc. Through the accessible data personal doctors
can frequently monitor pulse rate and condition of the patient. If patient
undergoes any physical checkups, the data obtained are fed to the individual’s account.
This allows patients to monitor their own health conditions and also notifies
on regular checkups which are fed in day planner of the patient. In case of
emergencies (such as fainting and reduction in pulse rate before reaching
critical level the fit bit gets alert and personal doctor, nearby general
doctor and three other caretakers (or Guardians) of the individual are made an
immediate alert message stating condition and location (latitude and longitude)
of the patient. Any of the people notified (especially nearby General Doctor)
sends ambulance to the location concerned. This project also deals with the
exception of doctor being an individual (patient). Signup page request for
Aadhar number which allows the account linked with Aadhar card and Doctor’s
Certification which include doctor’s official id (if any).This helps people to
make a trustworthy connection with Certified Doctors. This aids patients with
serious disorders with recommendations of Best Doctors across nation. Future
updations may include Hospital authority to create a local group of doctors of
unique specialization fields, so that, the patient can get helps within the
environment of his/her day-to-day life.

 

     Fig 4. Simple Schematic Diagram explaining working of Smart Virtual
Patient Monitoring System 1

IV.      
CONCLUSION

Though India has been reaching heights in the field of
medicine, it is not much capable in comparison with rise of  threats of chronic threats and lack of
sufficient facilities in remote areas. Also the technological approaches
nowadays has become a costly approach. Peoples in remote areas when delayed in
diagnosis and treatment may lead to loss of human resources. So it is necessary
to consider ‘Timely Approach’. Advancements in wireless technologies and
wearable sensor tech has opened doors to many ideas and creations. The proposed
project comprised of Android Handheld device, wearable sensor and web
interface. Web interface helps a doctor not only monitor a single patient but
also contact with series of patients. However hardware faults may produce false
alarms which can be rectified on future extensions and updations.

V. 
REFERENCES

1
Images
from shutterstock images

2
Gay V, Leijdekkers P. A health monitoring system using smart phones and

wearable
sensors. IJARM 2007;8(2):29–36

 

3
Jones V, Gay V, Leijdekkers P. Body sensor networks for mobile health monitoring:
experience in Europe and Australia. In: The fourth international conference on
digital society, ICDS 2010, February 10–16, 2010, Netherlands Antilles; 2010

 

4
 Pravin Pawar ,
Val Jones, Bert-Jan F. van Beijnum, Hermie Hermens . A framework for
comparison of mobile patient monitoring systems : Journal of Biomedical
Informatics 45 (2012) 544–556

5
Tan J, editor. E-Healthcare information systems: an introduction for students and
professionals. Jossey-Boss; 2005. ISBN 13 978-0-7879-6618-8

 

6
 Tan J. E-health prospects: mobile
health, virtual reality and consumer driven ehealth systems. In: E-healthcare
information systems: an introduction for students and professionals.
Jossey-Boss; 2005. p. 523–53. ISBN 13 978-0-7879-6618-8.

 

7  Eysenbach G. What is e-health? J Med Internet
Res 2001;3(2) June 18.

 

8
Istepanian RSH, Pattichis CS, Laxminarayan S. Ubiquitous M-health systems and
the covergence towards 4G mobile technologies. In: M-health: emerging mobile
health systems. Springer; December 2005. p. 3–14

 

9https://www.informationweek.com/mobile/remote-patient-monitoring-9-promising-technologies/d/d-id/1110968?page_number=5

 

10 https://www.vivifyhealth.com

 

11https://getreferralmd.com/2016/01/healthcare-technology-2016/

12
Priyanka Kakria, N.K.Tripathi, Peerapong Kitipawang : A Real-Time Health
Monitoring System for Remote Cardiac Patients Using Smartphone and Wearable
Sensors; International Journal of Telemedicine and Applications Volume 2015,
Article ID 373474

 

13
W. H. Organization, Global Status
Report on Noncommunicable Diseases 2010, World Health Organization, Geneva,
Switzerland, 2011.

 

14 Lin
YH, Jan I, Ko PC, Chen Y, Wong J, Jan G. A wireless PDA-based physiological monitoring
system for patient transport. IEEE Trans Inf Technol Biomed 2004;8(4).

 

15
Leijdekkers P, Gay V, Barin E. Feasibility study of a non invasive cardiac

rhythm
management system. IJARS – Int J Assist Robot Syst 2010 special edition.

 

16
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Halteren AT, Bults R, Wac K, Konstantas D, Widya I, Dokovsky N, et al. Bile patient
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17
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18
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for telemedicine. In: 8th Pacific Rim conference on multimedia (PCM 2007), Hong
Kong, China: Springer Verlag; 11–14, December 2007. p. 590–9.

ISBN
978-3-540-77254-5.

 

19
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project deliverable; March 2003

 

20
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made
feasible through use of EIS platforms. In: IMTC 2003 –

Instrumentation
and measurement technology conference, Vail, CO, USA;

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May 2003

 

21
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ServiceS.
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2005

 

22
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Biosignal
and context monitoring: distributed multimedia applications of

body
area networks in healthcare. In: Proceedings of the 2008 IEEE 10th

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23 Myotel: Myofeedback based teletreatment service.

accessed 07.19.10, archived by WebCite_ at .

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