Telemedicine is producing a great impact in the monitoring of patients located in remote nonclinical environments such as homes, military bases, ships, and the like. A number of applications, ranging from data collection, to chronic patient surveillance, and even to the control of therapeutic procedures, are being implemented in many parts of the world.
As part of this growing trend, in this paper, we present a real-time remote patient monitoring service through World Wide Web (WWW), which allows physicians to monitor their patient in remote sites using popular Web browser.
A prototype system is composed of data acquisition and pre processing module connected to the computer as the remote site via its RS-232 port, two personal computers equipped with network and analog to digital cards, and software modules to handle communication protocols between data acquisition module and personal computer.
The purpose of the system is the provision of extended monitoring for patients under drug therapy after infarction, data collection in some particular cases, remote consultation, and low-cost ECG monitoring for the elderly.
MATERIALS AND METHODS:
This paper presents an internet-based ECG tele monitoring system, which has been developed as an instance of the general client-server architecture presented in Figure 1.
The data acquisition module (DAM) is a device that allows acquisition and training aside from knowledge of widespread and standard Internet tools. The function of each one of the components of the proposed tele monitoring system and the detail regarding their implementation will be described in the following sections.
Data Acquisition Module (DAM):
The data acquisition subsystem was designed taking into consideration the requirements of a nonclinical situation. The device should be easily connected to the remote computer and should not require any adjustments to be made by the patient.
A block diagram of the DAM is shown in Figure 2. The DAM was implemented as a battery operated device. A LM 32 4 Instrumentation amplifier IC was used for amplification due to its improved characteristics. The signal should be amplified as close to the source as possible to alleviate loss of representation.However, the gain of the signal should not be too high to prevent DC offset and noise saturating the amplifier.
Client And Server Applications:
The client server architecture (see Figure 1) is defined as follows: the client application provided visualization, archiving, transmission, and contact facilities to the remote user (i.e.,the patient). And provides control of the acquisition module. The server, which is located at the physician’s end takes care of the incoming data, and organizes patient sessions.
The client application has been designed and developed using VB Script in Asp page, and the server application designed and developed using HTML and Macromedia Dreamweaver MX 2004. Execution of the client’s application generates the GUI shown in Figure 3. The client’s application is mainly to measure the patient’s heart rate, temperature and based on the waveform generated by (DAM) capture ECG waves in real time.
The sequence of the web pages according to the measurements process. It requires the user name and password to access the system web site. Then after these pieces of information are typed in, the page for view the patient’s ECG history and current online patients.
Zero indicates that the patient is offline status whereas one indicates the active mode or in i.e. the patient is undertaking his ECG test somewhere. After the symptoms are given, then the physician can click in the patient who appears online to view the patient’s measurements.The patient details such as name, age, address and IC, the current heart rate and temperature. The real time ECG waveform, which was recorded at the remote side.
The design of a complete real-time ECG acquisition, transmission, storage, and visualization system, which is easy to use and dedicated for clinical applications, has been presented in this paper. A Micro controller-based small-sized ECG DAM remotely control led and adjusted has also been presented. This device does not require any involvement or maintenance by the patient.
The client server interconnections are easily accomplished, and the contact window allows excellent version. The system used to monitor one patient. In the future, the system can be extended to monitor more than one patient at the same time and the server application could include more sophisticated signal processing analysis. Also, we plan to add video conferencing capability for the users under the networking environment where video data can be handled.
Source: University Putra Malaysia
Authors: Khalid Mohamed Alajel | Khairi Bin Yosuf| Abdul Rhman Ramli| El Sadig Ahmed