A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background: Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods: The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results: The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions: The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services

Can smartwatches replace smartphones for posture tracking?

This paper introduces a human posture tracking platform to identify the human postures of sitting, standing or lying down, based on a smartwatch. This work develops such a system as a proof-of-concept study to investigate a smartwatch's ability to be used in future remote health monitoring systems and applications. This work validates the smartwatches' ability to track the posture of users accurately in a laboratory setting while reducing the sampling rate to potentially improve battery life, the first steps in verifying that such a system would work in future clinical settings. The algorithm developed classifies the transitions between three posture states of sitting, standing and lying down, by identifying these transition movements, as well as other movements that might be mistaken for these transitions. The system is trained and developed on a Samsung Galaxy Gear smartwatch, and the algorithm was validated through a leave-one-subject-out cross-validation of 20 subjects. The system can identify the appropriate transitions at only 10 Hz with an F-score of 0.930, indicating its ability to effectively replace smart phones, if needed

Healthcare PANs: Personal Area Networks for trauma care and home care

The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to show that if the expertise of the on-site paramedic team can be supported by immediate and continuous access to and communication with the expert medical team at the hospital, patient outcomes can be improved. After care also influences the ultimate recovery of the patient. After-treatment follow up often occurs in-hospital in spite of the fact that care at home can offer more advantages and can accelerate recovery. Based on emerging and future wireless communication technologies, in a previous paper [1] we presented an initial vision of two future healthcare settings, supported by applications which we call Virtual Trauma Team and Virtual Homecare Team. The Virtual Trauma Team application involves high quality wireless multimedia communications between ambulance paramedics and the hospital facilitated by paramedic Body Area Networks (BANs) [2] and an ambulance-based Vehicle Area Network (VAN). The VAN supports bi-directional streaming audio and video communication between the ambulance and the hospital even when moving at speed. The clinical motivation for Virtual Trauma Team is to increase survival rates in trauma care. The Virtual Homecare Team application enables homecare coordinated by home nursing services and supported by the patient's PAN which consists of a patient BAN in combination with an ambient intelligent home environment. The homecare PAN provides intelligent monitoring and support functions and the possibility to ad hoc network to the visiting health professionals’ own BANs as well as high quality multimedia communication links to remote members of the virtual team. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by supporting care at home; the economic motivation is to replace expensive hospital-based care with homecare by virtual teams using wireless technology to support the patient and the carers. In this paper we develop the vision further and focus in particular on the concepts of personal and body area networks

3-D pain drawings-mobile data collection using a PDA

A large number of the adult population suffers from some kind of back pain during their lifetime. Part of the process of diagnosing and treating such back pain is for a clinician to collect information as to the type and location of the pain that is being suffered.Traditional approaches to gathering and visualizing this pain data have relied on simple 2-D representations of the human body, where different types of sensation are recorded with various monochrome symbols. Although patients have been shown to prefer such drawings to traditional questionnaires, these pain drawings can be limited in their ability to accurately record pain. The work described in this paper proposes an alternative that uses a 3-D representation of the human body, which can be marked in color to visualize and record the pain data. This study has shown that the new approach is a promising development in this area of medical practice and has been positively received by patients and clinicians alike

The INCA System: A Further Step Towards a Telemedical Artificial Pancreas

Biomedical engineering research efforts have accomplished another level of a ldquotechnological solutionrdquo for diabetes: an artificial pancreas to be used by patients and supervised by healthcare professionals at any time and place. Reliability of continuous glucose monitoring, availability of real-time programmable insulin pumps, and validation of safe and efficient control algorithms are critical components for achieving that goal. Nevertheless, the development and integration of these new technologies within a telemedicine system can be the basis of a future artificial pancreas. This paper introduces the concept, design, and evaluation of the ldquointelligent control assistant for diabetes, INCArdquo system. INCA is a personal digital assistant (PDA)-based personal smart assistant to provide patients with closed-loop control strategies (personal and remote loop), based on a real-time continuous glucose sensor (Guardian RT, Medtronic), an insulin pump (D-TRON, Disetronic Medical Systems), and a mobile general packet radio service (GPRS)-based telemedicine communication system. Patient therapeutic decision making is supervised by doctors through a multiaccess telemedicine central server that provides to diabetics and doctors a Web-based access to continuous glucose monitoring and insulin infusion data. The INCA system has been technically and clinically evaluated in two randomized and crossover clinical trials showing an improvement on glycaemic control of diabetic patients

Information Interface - Volume 30, Issue 4 - August/September 2002

News and information about Himmelfarb Health Sciences Library of interest to users

Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

Diseño e implementación de un Sistema embebido

This article presents the design and implementation of an embedded system called TES ROv2.0 non-invasive, capable of capturing and transmitting relevant biomedical signals such as: electrocardiography signals, heart rate, oxygen saturation in the blood and arterial pressure with the Support from the Clinical Information System called "SARURO", in which a detailed process of these biomedical signals is visualized and carried out by a doctor or specialist, without direct contact with the patient. Therefore, researchers have been able to affirm that integrated systems are tools that offer great versatility in the medical information market, allowing acquisition, adaptation, transformation in remote places, without linking operation to a single communication alternative, making the Telemonitoring system more versatile in its functionality to transmit over WPAN, WLAN, LAN and CELULARE networks.Este articulo presenta el diseño e implementación de un sistema embebido llamado TES ROv2.0 no invasivo, capaz de capturar y transmitir señales biomédicas relevantes como: las señales de electrocardiografía, frecuencia cardíaca, la saturación de oxígeno en la sangre y la presión arterial con el apoyo del  Sistema de Información clínico llamado "SARURO", en el cual se visualiza y efectúa un proceso detallado de estas señales biomédicas por parte de un médico o especialista, sin el contacto  directo con el paciente. Por tanto, los investigadores han podido afirmar que los sistemas integrados son herramientas que ofrecen una gran versatilidad en el mercado de la información médica, lo que permite la adquisición, adaptación, transformación en lugares remotos, sin ligar el funcionamiento a una única alternativa de comunicación, haciendo al sistema de telemonitorización más versátil en su funcionalidad para transmitir por redes WPAN, WLAN, LAN y CELULARES

A Review on Provisioning Quality of Service of Wireless Telemedicine for E-Health Services

In general, on-line medical consultation reduces time required for medical consultation induces improvement in the quality and efficiency of healthcare services. All major types of current e-health applications such as ECG, X-ray, video, diagnosis images and other common applications have been included in the scope of the study. In addition, the provision of Quality of Service (QoS) for the application of specific healthcare services in e-health, the scheme of priority for e-health services and the support of QoS in wireless networks and techniques or methods for IEEE 802.11 to guarantee the provision of QoS has also been assessed. In e-health, medical services in remote locations such as rural healthcare centers, ambulances, ships as well as home healthcare services can be supported through the applications of e-health services such as medical databases, electronic health records and the routing of text, audio, video and images. Given this, an adaptive resource allocation for a wireless network with multiple service types and multiple priorities have been proposed. For the provision of an acceptable QoS level to users of e-health services, prioritization is an important criterion in a multi-traffic network. The requirement for QoS provisioning in wireless broadband medical networks have paved the pathway for bandwidth requirements and the real-time or live transmission of medical applications. From the study, good performance of the proposed scheme has been validated by the results obtained. The proposed wireless network is capable of handling medical applications for both normal and life-threatening conditions as characterized by the level of emergencies. In addition, the bandwidth allocation and admission control algorithm for IEEE 802.16- based design specifically for wireless telemedicine/e-health services have also been presented in the study. It has been concluded that under busy traffic conditions, the proposed architecture can used as a feasible and reliable infrastructure network for telemedicine