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Mobile telemedicine system full report
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Effective emergency mobile telemedicine and home monitoring solutions are the thrust areas discussed in this study. Ambulances, Rural Health Centers (RHC) or other remote health location such as ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the various growing application areas explained above a combined real-time store and forward facility that consists of a base unit and a telemedicine (mobile) unit is used. This integrated system can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site. This enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital bio signals (ECG, SP02, NIBP, IBP, Temperature) and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case.

Mobile telemedicine is defined as the delivery of health care and sharing of medical knowledge over a distance using telecommunication means. Thus, the aim of telemedicine is to provide expert-based health care to understaffed remote sites and to provide advanced emergency care through modern telecommunication and information technologies. This integrated system can be used when handling emergency cases in ambulances, rural health centers (RHC) or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site. This enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital bio signals and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Today, mobile telemedicine systems are supported by State of the Art Technologies like Interactive video, high resolution monitors, high speed computer networks and switching systems, and telecommunications superhighways including fiber optics, satellites and cellular telephony
Critical care telemetry is another case of handling emergency situations. The main point is to monitor continuously intensive care units' (ICU) patients at a hospital and at the same time to display all telemetry information to the competent doctors anywhere, anytime. In this pattern, the responsible doctor can be informed about the patient's condition at a 24-hour basis and provide vital consulting even if he's not physically present. This is feasible through advanced telecommunications means or in other words via telemedicine. Another important telemedicine application area is home monitoring.

Telemedicine system is able to handle different critical problems in the area of distant medication like:
¢ Emergency health care provision in ambulances, Rural Hospital Centers (or any other remote located health center) and navigating Ships
¢ Intensive care patients monitoring
¢ Home telecare, especially for patients suffering from chronic or permanent diseases (like heart disease).
Mobile telemedicine is a "Multi-purpose" system consisting of two major parts: a) Telemedicine unit and b) Base unit or doctor's unit
Figure 1 describes the overall system architecture. The Telemedicine unit is located at the patient's site, whereas the base unit (or doctor's unit) is located at the place where the signals and images of the patient are sent and monitored. The Telemedicine device is responsible to collect data (bio signals and images) from the patient and automatically transmit them to the base unit. The base unit is comprised of a set of user-friendly software modules, which can receive data from the Telemedicine device, transmit information back to it and store important data in a local database. The system has several different applications, according to the current healthcare provision nature and needs.
Before the system's technical implementation, an overview of the current trends and needs in the aforementioned Telemedicine applications was made, so that the different requirements are taken into account during design and development, thus ensuring maximum applicability and usability of the final system in distinct environments and situations. Table provides the results of this overview, which was done towards a predefined list of criteria that usually influence a Telemedicine application implementation (cost, portability, autonomy, weight and size of Telemedicine device, type and quality of PC and camera, communication means used).

As mentioned above, the system consists of two separate modules (Figure 1): a) the unit located at the patient's site called "Telemedicine unit" and b) the unit located at doctor's site called "Base Unit". The doctor might be using the system either in an emergency case or when monitoring a patient from a remote place. The design and implementation of the system was based on a detailed user requirements analysis, as well as the corresponding system functional specifications. The Telemedicine unit is responsible for collecting and transmitting bio signals and still images of the patients from the incident place to the doctor's location while the doctor's unit is responsible for receiving and displaying incoming data.
The information flow between the two sites can be seen in Figure 2. The software design and implementation follows the client server model. The Telemedicine unit site is the client while the Base unit site is the server. Communication between the two parts is achieved using TCP/IP as network protocol, which ensures safe data.

The Telemedicine unit mainly consists of four modules, the bio signal acquisition module, which is responsible for bio signals acquisition, a digital camera responsible for image capturing, a processing unit, which is basically a Personal Computer, and a communication module (GSM, Satellite or POTS modem).
The bio signals collected by the patient (and then transmitted to the Base Unit) are:
¢ Oxygen Saturation (Sp02).
¢ Heart Rate (HR).
¢ Non-Invasive Blood Pressure (NIBP).
¢ Invasive blood Pressure (IP).
¢ Temperature (Temp)
¢ Respiration (Resp)
Data interchange is done using the TCP/IP network protocol, which allows operation over several communication means. The PC is equipped with the proper modem for each case, i.e. GSM, Satellite or POTS. The design was done for standard Hayes modems. Several modems types were used for testing: GSM 900 modem-for GSM NW POTS modem 56K-for telephone nw
The Telemedicine unit is also responsible for the collection and transmission of images of the patient to the base unit,a digital camera responsible for image capturing. Several cameras were used while testing the system:
a) ZOOM digital camera connected to the PC's parallel port model 1585.
b) ZOOM digital camera connected to the PC's usb port model 1595.
c) Creative camera connected to usb .
The control of the Telemedicine unit is fully automatic. The only thing the telemedicine unit user has to do is connect the bio signal monitor to the patient and turn on the PC. The PC then performs the connection to the base unit automatically. Although the base unit basically controls the overall system operation, the Telemedicine unit user can also execute a number of commands. This option is useful when the system is used in a distance health center or in a ship and a conversation between the two sites takes place.
The base unit mainly consists of a dedicated PC equipped with a modem, which is responsible for data interchange. In addition the base unit pc is responsible for displaying incoming signals from the Telemedicine unit. When an expert doctor uses the base unit located outside the hospital area, a portable PC equipped with a GSM modem or a desktop PC equipped with a POTS modem is used. When the base unit is located in the hospital, a desktop PC connected to the Hospital Information Network (HIS) equipped with a POTS modem can additionally be used; the expert doctor uses it as a processing terminal.

Biosignals mode Still image mode
Figure 4 :Control Windows - Base Unit


Telemedicine Network

Figure 5: Telemedicine Network control - Base Unit

The user is able to monitor the connection with a client (telemedicine unit), send commands to the telemedicine unit such as the operation mode (bio signals or images) Figure 4. In cases were the base station is connected to a Hospital LAN the user can choose to which of the telemedicine units to connect to, as shown in Figure 5 the user of the base unit is able to choose and connect to anyone of the telemedicine units connected on the network.
Figure 6 presents a typical bio signal-receiving window (continuous operation). When the system operates on still image mode, the doctor can draw-annotate on the image and send the annotations back to the Telemedicine unit. When operating on bio signal mode (Figure 6), the transmission of vital bio signals can be done in two ways, continuous way or store and forward way, depending on the ECG waveform channels which are transmitted and the telecommunication channel data transfer rate. In continuous operation, the Base Unit user can send commands to the Telemedicine Unit monitor, such as lead change or blood pressure determination; the user can also pause incoming ECG, move it forward or backward and perform some measurements on the waveform.
Images captured by the Telemedicine unit's camera have resolution 320 * 240 pixel and are compressed using the JPEG compression algorithm; the resulting data set is approximately 5-6 KB depending on the compression rate used for the JPEG algorithm .
Two major portable monitors firms were used in this study, which can provide three to twelve leads waveform of ECG and numeric data from other bio signals (HR, Sp02, NIBP, IP, Temp). The first of the monitors used, CRITIKON DfNAMAP PLUS Monitor has a digital output of a continuous one channel ECG plus bio signals such as NIBP, Sp02, HR, IP and data concerning monitor alarms etc.
The second of the monitors used, PROTOCOL Propaq Monitor has a digital output of a continuous one (model lxx) or two (model 2xx) channels ECG, plus another waveform such as Sp02 or Co2; plus bio signals trends such as NIBP, Sp02, HR, IP and data concerning monitor alarms etc. All above information can be transferred using up to 2400 BPS for one channel ECG, up to 4400 for two channels of ECG or up to 5400 for two channels of ECG plus another waveform (Sp02 or Co2). For this reason, the continuous transmission of signals from this monitor can be done when using GSM and POTS but only one lead ECG when using 2400 BPS satellite links.
In order to decrease data size, a lossless ECG compression algorithm based on Huffman coding algorithm is implemented in the system and can be applied on transmitted signals, when needed by the Base Unit user.
An encryption algorithm was implemented in the system and can be used when needed by the hospital unit user. The system can encrypt interchanged data using the Blowfish cipher algorithm . The use of encryption is optional and can be selected by the user; authentication and connection between base and telemedicine units is done using encrypted messages.
The system has been clinically tested through installation and extended validation of the system in a number of distinct demonstration sites across Europe. More specifically the use of the developed system in emergency cases handling in ambulances has been extensively demonstrated in Greece, Cyprus, Italy and Sweden. The initial demonstration of the system for ambulance emergency cases was performed on 100 emergency cases for each hospital.
The use of system in Rural Health Centers has been tested extensively tested in Cyprus. The use of the system in a Ship is currently being used in Athens Greece and finally the use in home telecare is also being tested in Athens Greece. The system is currently installed and being used in two different countries, Greece and Cyprus.
Current technology has severe inadequacies that need addressing. Firstly the capability of current system is limited by the bandwidth availability of the data transmission tools like GSM. Future work would concentrate on improving the message transmission making the system response fast. This would enhance the current technology to reach people at a much larger scale.
We have developed a medical device for telemedicine applications. The device uses GSM mobile telephony links, Satellite links or POTS links and allows the collection and transmission of vital bio signals, still images of the patient and bi-directional telepointing capability. The advance man-machine interface enhances the system functionality by allowing the users to operate in hands-free mode while receiving data and communicating with specialists. The final system is currently installed and used in two different countries Greece and Cyprus. Results from the system use are very promising thus encouraging us to continue the development and improvement of the system in order to be able to cover additional future needs.

Page No:
Mobile telemedicine system
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Post: #2
Wink i want this topic send to my email
Post: #3
Post: #4
hey post it to my email id...


Post it to....

Post: #5
This article is presented by:
a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting, and sometimes remote medical procedures or examinations

the delivery of medical health care and medical expertise using a combination of telecommunications technologies

Tele-emergency project based on three technologies viz., MIPv6, MANET, and WLAN,a highly capable system with the ability to be rapidly deployed to support medical services


Enables mobile computers to stay connected to the Internet regardless of their location and without changing their IP address

Based on TCP/IP protocol suite which has 4 layers: application layer, transport layer, network layer, and link layer

Basic function is to deliver data from a source to a destination independent of the physical location of the two

Post: #6
[font=Times New Roman][size=medium]
Post: #7
the full report has been posted in the first page of this thread. Please go there.
for a related topic, see:
Post: #8



By deploying telecommunications technologies to deliver health care and share medical knowledge over a distance, telemedicine aims at providing expert-based medical care to any place and at any time health care is needed. When the first telemedicine services were provided, telemedicine applications were implemented over wired communications technologies such as plain old telephone network (POTN) and integrated services digital network (ISDN).Recent developments in telemedicine resulting from wireless advances are promoting wireless telemedicine, also referred to as m-health or mobile health. Normally, wireless telemedicine systems consist of wearable medical devices and wireless communications networks.
Wireless communications overcomes most geographical, temporal,and organizational barriers to the transfer of medical data and records.In order to provide ubiquitous availability of multimedia services and applications, wireless and mobile technologies are evolving towards integration of heterogeneous access networks such as wireless personal area networks (WPANs), wireless local area networks (WLANs), wireless metropolitan area networks (WMANs) as well as third-generation (3G) and beyond 3G cellular networks.
A hybrid network based on IEEE 802.11/WLANs and IEEE 802.16/WiMAX is a strong contender since both technologies are designed to provide ubiquitous low cost, high-speed data rates, quality of service (QoS) provisioning, and broadband wireless Internet access.IEEE 802.11/WLAN is the standard to provide moderate- to high-speed data communications in a short range generally within a building. The IEEE 802.16/WiMAX is the standard to provide broadband wireless services requiring high-rate transmission and strict QoS requirements in both indoor and outdoor environments.Various advanced medical applications such as remote follow-up, remote diagnosis, intervention on non-transportable patients, remote monitoring, remote assistance, and medical e-learning are expected to be improved by using WiMAX.

Mobile telemedicine systems can be deployed for emergency telemedicine services, mobile patient monitoring, and mobile health service provider. Security is a significant requirement for any communication environment; a mobile healthcare system with patient monitoring is no exception.Although real-time monitoring and data transmission provides necessary information quickly, it also can expose a patient’s medical data to malicious intruders or eavesdroppers.If an m healthcare system lacks the necessary protection when communicating data, unauthorized parties or persons can easily access the private data of a patient, medical records may be modified freely by malicious attackers, and false information can be injected into the data stream by a prohibited node.
As a result, when planning mobile health-care systems, security is indispensable because of the shared nature of wireless devices, the mobility of the patients, and the susceptibility of dynamic and pervasive environments. Due to the important function of m-healthcare, patient monitoring can be a vulnerable point by which an attacker may jeopardize the entire functioning of the system, and even mislead medical professionals to make improper decisions.
In this we study the issues of patient monitoring from the viewpoint of mobile healthcare, and show how current secure strategies are applied to achieve the security and privacy requirements.In next we briefly describe the reliability, efficiency and security issues of m-healthcare and BSNs. Subsequently,we focus on the techniques of patient monitoring and secure healthcare mechanisms. Finally,we present our conclusions.


WLANs are commonly used in their 802.11a, 802.11b, and 802.11g versions to provide wireless connectivity in home, office, and some commercial establishments; they are also widely deployed in telemedicine systems. Since the early 1990s,the industrial, scientific, and medical bands,2.4GHz and 5 GHz, have been made available for WLAN, among which the 802.11b and 802.11g protocols are the most popular.IEEE 802.11 WLANs are most suitable for local telemedicine services, IEEE 802.11e can be used for transmitting sensitive medical data with QoS support, and IEEE 802.11i provides security support as an amendment to the original IEEE 802.11 standard by specifying securitymechanisms for WLANs. However, WLANs have limitations in terms of mobility and coverage area.
IEEE 802.16/WiMAX is a good last-mile wireless access solution that provides baseline features for flexibility in spectrum to be used all over the world. Advantages of using WiMAX for wireless telemedicine applications over WLAN-based systems can be summarized as follows:
• Broadband wireless access in both fixed and mobile environments
• High bandwidth to reduce transmission delay of quality images significantly
• Integrated services provided by the large network capacity of WiMAX enabling fully functional telemedicine services such as various types of diagnostics, physical monitoring pharmaceutical and drug dosage management services, good quality conversational communications between a physician and a patient,and consultation among medical specialists

• Medium access control (MAC) layer security features of WiMAX providing access control and encryption functions for wireless telemedicine services
• QoS framework defined in 802.16e enabling efficient and reliable transmission of medical data
The most fundamental difference between WLAN and WiMAX is that they are designed for totally different applications.
• WLAN is the standard to provide moderate- to high-speed data communications within a short range, generally within a building.
• WiMAX is the standard to provide Internet access over a long range outdoor environment.
• All WLAN implementations use unlicensed frequency bands, but WiMAX can operate in either licensed or unlicensed spectrum.

Post: #9
hello sir/madam,
can you please mail me the figures related to the telemedicine report(which are mentioned in the report)..they are not getting displayed.Kindly oblige.Please mail it to this id...
Post: #10
please send wireless mobile telemedicine full report...........
Post: #11
to get information about the topic Telemedicine full report ,ppt and related topic refer the link bellow

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