patient vital signs monitoring via android application
TRANSCRIPT
-
7/25/2019 Patient Vital Signs Monitoring via Android Application
1/4
2015 International Conference on Advances in Biomedical Engineering ICABME)
Patient Vital Signs Monitoring via Android Application
Roy ABI ZEID DAOU
Lebanese German University,
Public Health Faculty,
Jounieh, Lebanon
Enlail: [email protected]
Ali HAYEK, JosefBORCSOK
Department of Computer
Architecture and
System Programming, University
of Kassel
Kassel, Germany
d iff er en t p ara m ete rs c on tro lla ble b y th e m e dic al d oc to r H ea rt
R a t e , SP02, N I B P , EeG, te m pe ra tu re a nd re sp ir atio n r ate ),
g en eratin g a da ily rep ort, a na ly zin g re sults an d n otify in g th e
c on ce rn ed p ar tie s w h en a q ue stio na ble s it ua tio n is r ec og niz ed .
A dd ed to tha t, th e m ed ica l do ctor can set fo r a n ap pointm ent o r
p re sc rib e a m e dic atio n to th e p ati en t. A n oth er im p or ta nt f ea tu re
o f th is sy stem is th at it e na bles th e co n n ection o f m ultip le
p atie nt s th at a re m o nito re d b y th e s am e h ea lth p ro fe ss io na l.
Elias AAD, Farid NAKHLE
Abstract This paper presents a system that is able to monitor
the patient vital signs (Heart Rate, SPO , NIBP, ECG,
temperature and respiration rate) and send them continuously to
the doctor s android phone device. The system enables multiple
patients to be connected to the same doctor. Within the system,
the health care professional may activate/deactivate any of the
vital signs sensors. He can also set a prescription for the patient,
schedule a meeting,... When bad activities are received, a
message is directly sent to the doctor and to the patient relatives
in order to alert them. Note that the Bluetooth connection is used
to send/receive data between the patient platform and its android
system. The tested results showed an almost errol free system
with an accuracy above 950/0 and a few milliseconds delay
between the vital signs reading and their upload over the server.
Keywords= tetemedicine: vital signs; btuetootn connection; real
time monitoring
I. INTRODUCTION
N ow ad ay s, telem ed ic ine is o n e o f th e m ost in cre asin g
te ch no lo gy a pp lic atio n a pp lie d to m e dic al f ie ld b ec au se o f th e
co st re du c tion it m ay o ffer an d th e fu ll m on ito ring ab ility it
insu res [1 ] [2 ]. E ve n th ou g h it w as lau n ch ed b y N AS A in th e
m id 60 s o f th e p re v iou s cen tu ry , th e im prov e m e n t in th is
d om a in r em a in ed s lo w u ntil th e s ta rt o f th e c ur re nt century,
W ith th e d ev elo p m en t of h ig h ly so p histic ated a nd fast
co m mun ic atio n to o ls, th e rea l-tim e m onito rin g b eca m e
acce ssib le an d th e d ev elo ped c oun tries fo un d a w ay , by usin g
telem edic in e, to red u ce th e h u g e b ills th ey m ust p ay fo r th e
h ealth sector [3 ]. H ow ev er, su ch system is still n ot p op ular in
u nd erd ev elo ped co un try as the re qu ired in frastru ctu re is n ot
re ad y to h an dle it [4 ].
T h e a pp lic atio ns in te le m ed ic in e a re d iv er se a nd g o f r0 11 1a
sim ple m ed ical d ata tran sm issio n a n d p roc essin g be tw ee n a
p atien t an d a h ea lth care p ro fessio nal to h igh ly so ph isticate d
de vices u sed in surg eries a s th e D aV in ci R ob ot [5] [6 ]. In fa ct,
te le m ed ic in e u su ally t ak es c on tr ol o f th e r eh ab ilita tio n p ro ce ss
an d en ab le s th e d o cto r o r th e m ed ica l staff to m on ito r th e
p atie nt h ea lth re m ote ly w ith ou t its p hy sic al p re se nc e. H en ce , a
re al-tim e tran sm issio n is n eed e d w ith a m in im al d elay tim e
b etw een sign al cap tu rin g from th e p atien t sid e an d the sig nal
p ro ce ss in g f ro m th e h ea lth c ar e p r of es sio na l s id e.
H en ce, th e p rop o sed w ork p rese nts a n o ve l ap p lica tio n
allo win g a do ctor to m onitor h is p atien t s h ealth a nytim e an d
an yw here v ia a co mm un ica tio n p ro to co l e na bling a real tim e
ex ch an g e of d ata o f the p atie n t s m ain v ita l sig n s. A s fo r th e
spe cificatio ns o f the sy stem , it allo ws th e m ea surem en t o f six
978-1-4673-6516-1/15/ 31.00 2015 IEEE
W he ne ve r m isco n d uc t is read fro m o n e o f th e se nso r, th e
p ro p o sed syste m sen d s a d irect n o tificatio n to th e m edic al
d o cto r an d to the p atien t s rela tiv es in ord er to alarm th em o f
i ts c r it ic a l c o n di ti on .
H en ce , th is p ap er w ill b e d iv id ed a s fo llo w : in s ec tio n 2 , t he
h ardw are sy stem w ill b e p resen ted . T he sen so rs d ep lo yed fo r
th e m ea surem en t o f th e six v ital sig ns are p ro po sed . In sec tio n
3 , th e so ftw are p art as w ell as th e co mm unic atio n to ols fo r da ta
tran sm issio n a re in tro d u ced . S ec tio n 4 sho w s th e w h o le
assem bled sy stem an d som e sce na rio s o f its u se. A t th e en d ,
sec tion 5 prese nts th e co n clu sio n o f th is w ork a nd p ro p o ses
s om e f utu re w o rk s.
II. HARD\VARECONFIGURATION
F ou r sen so rs w ere im plem ente d in o rd er to m easu re th e
p atie nt s v ital sig n s. T h e sen sors a re co n tro lle d b y a b o ard,
w h ic h is eq uipp ed b y a B lu eto o th m o d u le an d a seria l
co m m unicatio n in terface [7 ]. F ig u re 1 rep resen ts the b lo ck
d ia gra m o f th e w h ole s ys te m .
c L ~ 1--: 1:---......._
\-~------4
0- -
STM32f103
Figure Block diagram of the hardware system from the patient side
166
-
7/25/2019 Patient Vital Signs Monitoring via Android Application
2/4
2015 International Conference on Advances in Biomedical Engineering ICABME
From this system, one can notice the presence of the
STTM32FI03 processor as well as the following sensors:
Temperature sensor ranging from 20C to 45C;
Pulse Oximetry (Sp02) ranging from 35 to 100 ;
5 lead ECG with a voltage ranging between O.SlnV and
5nlVwith up to 4000 samples/second/channel;
NIBP with a measurement range of 30mmHg-255nunHg
for the systolic blood pressure and ISnunHg-220nunHg
for the diastolic blood pressure;
These sensors perform the following additional
measurements:
Heart rate measurement ranging froIn 20 to 300 BPM from
the ECG and the SP02 sensors;
Respiratory wave that uses the chest impedance
measurement method from the ECG sensor with a
sampling range reaching 100 SPM;
Added to that, a power supply and a Bluetooth connection
are embedded on this board. The latter part will be developed
Added to that, a power supply and a Bluetooth connection
are embedded on this board. The latter part will be developed
in more details in section 3.
As for the signals processing and amplification, different
filters were used, mainly for the ECG [8] [9] [10].
As
the
module could be connected to the power line, a notch filter
was a must. This notch filter was responsible to eliminate the
noise generated by the sector line. In addition, the band pass
filter was implemented in order to eliminate all frequencies
lower than 0.5Hz or greater than 150Hz.
Concerning the implementation of these filters, it can be
done by software or by hardware. A hardware implementation
may give better results but needs more time and costs more
money. However, we have chosen to implement the notch
filter along with a pre-amplification stage physical whereas for
the band pass filter, the muscles movement noise and the
second amplification stage, they are implemented within the
code.
III SOFTvVAREAND COM1vftJNICATION TOOLS
This section will be divided into two parts: in the first
one, the software running and handling all electrical/electronic
sensors is presented whereas the second part deals with the
co mm unication too ls needs in order to keep the docto r updated
with the evolution of his patients health.
Software implementation
The first part shows the connectivity hierarchy of this
system. Once the data, COIningfrom any of the connected
sensors, is captured by the processor, it is sent, via the
Bluetooth connector, to the patient device. is then sent to a
se rve r
that is accessible by the doctor. Figure 2 shows the
block diagram of the connectivity hierarchy consisting of the
patient, the health care professional and the patient s relative.
Note that this latter is found in this block diagram because an
automatic message is generated when a mal-functionality is
found in at least one of the patients vital signs.
:
STMJ2f103
Figure
2 -
Block diagram of the connectivity hierarchy
B Communication tools
B Communication tools
As for the c o m m u n i c a t i o n two modes are allowed: the
wireless communication via Bluetooth and the serial wired
communication. The first module will be the primary
communication method. Thus, it is mostly used as the data
will be sent wirelessly to the patient mobile device before
being transferred to the cloud.
Different tools are used for the control of the data
transmission. Once the Bluetooth is connected, the mobile
application asks for the login credentials of the patient. Based
on the patient s identity, already stored on the se rve r the
application fetches the appropriate information and commands
related to it from the remote se rve r These information and
commands are pre-configured by the doctor from his special
control backend installed on his phone. Once this procedure is
completed, selected modules will be enabled or disabled
accordingly by sending the corresponding control orders to the
b o a r d
In fact, the sensors will keep monitoring their specific
parameters. However, only the required vital signs requested
by the doctor meprocessed by the application and sent to the
server. is up to the processor of the board responding to the
commands received to select the data to be sent. During the
program ming and in order to lim it congestion on ly the
required data by the doctor is sent from the patient side to the
se rve r
However, if the doctor doesn t specify any data, all six
vital signs are sent to the server and they are directly
accessible by the doctor. Here, we must note that the data
transmission speed differs from one sensor to the other
depending on the size of the block to be sent and the expected
changes in the vital sign over time.
As the medical professional is the administrator of the
system, he can access the data anytime and anywhere to view
it, enable/disable any of the sensors, set a medication or a
meeting and so on.The doctor can also change the parameters
-
7/25/2019 Patient Vital Signs Monitoring via Android Application
3/4
2015 International Conference on Advances in Biomedical Engineering ICABME
configuration or require a new reading. Once a change is
capture from the doctor s side, the board reconfigures the
enabled/disabled sensors, reads all the values and sends the
required ones to the server.
To sum up, figure 3 shows the flowchart containing the
whole process starting from the login authentication till the
data fetching within the server.
lI ,onOt o~ )
A r p I ~
~
~
_ CtlJlltllll;
U :tlII~
l
~Jw_
r t .d1 ll tJ . .
t
J
~dlttlO
..
~/
ril t Ui
I
~
l~ua
l
igure
3-
oftware processing flow chart
Concerning the health care professional backend, a cross
platform application, developed for Android and lOS systems
using PHP, was proposed. TIns program is installed on his
phone and can be accessed from any web browser as well. t
helps to offer full control over the patient s device.
Not only will the doctor be able to add prescriptions and
view appointments, but he will also be able to request an on
demand test for the patient in order to checkup on his current
health status.
Added to that, the data history of eve Y patient will be
saved for easy and fast comparison between its current
conditions and its previous ones. These tests results are saved,
sorted and displayed by date and time. On another hand, up on
patients approval, their data can be donated to universities
and laboratories for medical studies and learning/teaching
purposes.
Figure 4 represents some screen shots of the application
from the medical professional side. In fact, one can notice a
screen shot to choose the patient, another one to read the
values of the tests, a third one for the history, a fourth one
containing the menu and the last one for the login
authentication.
5
igure
4 -
creen shots of the application from the doctor side
IV.
AsSEMBLY TECHNICS
In this fourth part, the diownstream exchange and the
upstream exchange technics will be presented. The
downstream exchange presents the communication from the
cloud to the board via the patient s phone. The incoming and
outgoing information exchanged with the board is partitioned
into packages of hexadecimal bytes specific for each sensor
and parameters required. The commands info packages sent
by the phone to the board using the Bluetooth module are
divided into 2 pruts:
1. A package head set by default to OX5 5 OXAA form ed
by 4 hexadecimal data sets;
2. A Data Package specific for each sensor to be activated
or disabled
formed
by 8 bits. This package struts with
a characterizing bit to select the appropriate sensor
needed.
As for the upstream exchange, it represents the
communication routing starting from the board to reach the
cloud and being accessible by the doctor s phone.
Once all commands are applied, the board responds with
information acquired from the sensors and, as already
described, it sends the data in hexadecimal format but this
time with different length depending on the activated sensor.
The data info packages sent by the board to the phone using
the Bluetooth module can be divided into two parts as follow:
1. A package head set by default to OX55 OXAA form ed by
four hexadecimal data sets;
2. A Data Package specific for each sensor to be activated
or disabled formed by 12 hexadecimal data sets. This
package starts with a characterizing Bit to specify the
parameter sent ECG - NIPB - SP0
2
Temp).
-
7/25/2019 Patient Vital Signs Monitoring via Android Application
4/4
2015 International Conference on Advances in Biomedical Engineering ICABME
Figure
5
Top view of the system/rom the patient side
V. CONCLUSION
A fter presenting the proposed system from a hardw are
and softw are points of view , this part w ill list the features of
the proposed system , w ill summarize the w ork done and w ill
p ro po se s ome fu tu re wo rk s.
C oncernin g th e system s features, they can be resum ed as
follow:
Tasks to be done in em ergency;
Capability of monitoring n10re than one patient by a
s ing le doc;
L ig ht w eig ht p orta ble d ev ic e;
S afe ty meas uremen ts;
As for the
summary,
we have proposed a system that
m easures six vital signs of a patient and transm it them to the
doctor via a web
server
that can be accessible anytim e and
anywhere. The main vital signs (Heatt Rate, SP0
2
NlBP,
ECG , temperature and respiration rate) are captured on a
board
carried
by the patient. Signals are being sent to the
server in order to be accessible anytim e/anywhere by the
d oc to r. T he la tte r c an a lso e na ble/d isa ble a ny o f th e se nso rs in
real tim e. The m edical history of the patient is also
stored
on
th e
server
and
alarms
for m edications and further
consu lta tio ns a re ava ila ble optio ns fo r th e sys tem .
Concerning the future works, lot of ideas can be
im plem ented to enrich this
system, As
a start, adding the
c ap ab ility to sto re d ata w hile b ein g o fflin e a nd sy nch ro niz in g
it once the connection is reestablished in no tim e is of m ajor
concern. A nother idea is to im plem ent a video call betw een
the doctor and his patient allowing a live consultation and
d ia gnos tic o f th e
observed
a bnorma litie s. In a dd itio n, a lower
power consumption system would be designed allowing a
better
battery
life to
allow
patients engage in longer tim e
outdoor activit ies .
O n another hand, the safety and security aspects m ust be
viewed in more details in order to reduce or to lim it the bad
e ffe cts th at th is sy stem m ay c au se to p atie nts e sp ec ia lly th at it
is co nnected to th em all day long . T hus, som e m ore cond ensed
com ponents m ay be used in order to let the patient feel m ore
comfor tabl e i n i ts movemen ts .
REFERENCES
[1] V .
Garshnek
an d F .
1.
Burk le , T e lemed ic in e app li ed to
d is as te r medi ci ne and
humanitarian
r es pon se : h is to ry and
future
in 32 nd A nnu al In terna tio na l C onferen ce o n
Syst ems Sc iences Hawa ii, 1 99 9.
[2 ] A . M a rtin ez , V . V illa rro el,
S eo an e a nd F . P oz o, R ura l
t el emed ic in e f or
primary
heal thcare in develop ing
countries,
IE EE T echn olog y an d So ciety M aga zin e
vol.
23,no.2,pp.13-22,2004.
[3 ] 1. Kyed ar, S uc ce ss s to rie s in T elemed ic in e: S ome
empirical
evidence, Jou rn al o f T elemed ic in e vo l. 9, n o.
1,2003.
[4 ] 1. Puus tj ar vi and L . Puus tj ar vi, Design ing a c loud-ba sed
mu lti na ti onal t el emedi ci ne eco sy st em for develop ing
countries, in 1 ST -A fric a Con fe re nc e a nd E xh ib itio n IS T-
Africa Nairobi , 2013.
[5] C . Iavazzo, X .-E . G keg ke, P .-E . lavazzo and Gkegkes,
E volut ion o f Robo ts Th roughou t
History
From
Hep ha estu s to D a V in ci R ob ot,
Acta Medico-His tor ica
Adriatica vol. 1 2, n o. 2 , p p. 2 47 -2 58 ,2 014.
[6] M . M argaritescu, A . M . E ulam pia R olea and V . V ad uva,
V irtu al Mode lin g o f a L ap ar os co pic S urg ic al Robo t w ith
Hybrid Kinemat ics,
Roman ia n R ev iew P re cisio n
Mechanics Optics
Mecatronics n o. 4 6, p p. 2 0-2 4,
2014.
[7 ] S . K in 1, C . B re nd le , H .- Y . L ee , M . \V alte r, S . G lo eg gle r,
S . K rueg er and S . L eo nhard t, E valu atio n of a 433 11Hz
B an d Bod y S en so r N etw ork fo r B iome dica l
Applications, Sensors vol. 3 , n o. 1 , p p. 8 98 -9 17 ,2 014.
[8] W . Y ubo , K . V eluvolu and L. M inho, Tim e-frequency
a na ly sis o f b an d-lim ite d E EG w ith BMFLC a nd K alm an
f il te r f or BCl appl ic at ion s, Journa l o fNeuroEngineering
Rehabilitation
v ol. 1 0, n o . 1 , p p. 1 -2 9,2 01 3.
[9 ] 1. Hogan, 1. Kroge r a nd 1. L ak ey , T im e a nd B an dp ass
L im itin g a nd a n A pp lic atio n to E EG , S amplin g T he ory
i n S igna l Image Proces sing vo l. 13, n o. 3 , p p. 295 -
313,2014.
[10] B .-G . Lee, B .-L . Lee and C. W an-Young, M obile
Heal th ca re f or Au tomat ic D r iv ing S leep -Onse t De tect ion
U sin g Wave le t-B a se d EEG and Re sp ira tio n S ig na ls ,
Sensors
vol. 1 4,n o.1 0,p p. 1 7915 -1 7936 ,2 014.
69