AN IMPROVED ECG SIGNAL ACQUISITION SYSTEM THROUGH CMOS TECHNOLOGY

Abstract: This paper presents the design and realization of low power, high gain PC based system for ECG and data acquisition of a patient's heart condition. The advantage of this system is the use of standard CMOS process which will reduce the complexity and cost of the manufacturer. The system consists of three subsystemsOperational Amplifier based Pre-amplifier, ADC and USB interface device. High gain around 85 dB, low power dissipation of typically 0.683 mW and 61.5 degree phase-margin for stable closed loop operations were achieved. All design and simulation were done using Tanner Tool 0.5 μm technology

Effectiveness of a handheld remote ECG monitor

This present study deals with designing a real-time remote handheld ECG monitoring system and evaluating its potential usefulness in early detection of heart conduction problems. The raw ECG recordings were sent by the handheld monitor (client) to a remote server, which performed an on-line ECG analysis and sent the results back to the client. Real-time feedback provided to the client included display of ECG, results of ECG analysis and alarms (if required). The objective of this work was to determine its effectiveness in real-time identification of particular pattern preceding ventricular fibrillation. The remote server identified the occurrence of QRS complex and premature ventricular contractions and monitored ECG for ventricular tachycardia and variations in heart rate variability indices. The sensitivity and specificity of the QRS detection to ECG recordings from MIT-Arrhythmia database were 99.34% and 99.31%, respectively. Similarly these parameters of the premature ventricular contraction detection were 87.5% and 91.67%, respectively. The time between alarm and the onset of ventricular fibrillation was measured on ECG recordings where premature ventricular contractions were found to lead to ventricular fibrillation. The remote monitor was able to successfully identify the onset on ventricular fibrillation. Early detection could contribute to better response to an emergency intervention. HRV indices sensitive to the differences between normal and subjects with congestive heart failure were monitored in real-time. They were heart rate, statistical index RMSSD, total spectral power, high frequency power and the ratio of low frequency to high frequency power (LFP:HFP). The effectiveness of HRV indices was tested on an ECG recording of a sleep study subject, who experienced cardiac arrhythmia. Cyclic changes observed in total spectral power prior to onset of cardiac arrhythmia could be attributed to REM sleep cycles. No other conclusive change in HRV indices was observed. The monitor's usefulness in predicting long-term prognosis of post-MI subjects was tested on ECG recordings from two subjects made immediately after conclusion of cardiac arrhythmia and during a follow-up visit. Both showed higher RMSSD, total spectral power and LFP:HFP ratio. Personalizing the monitor for each patient further improves its accuracy in measurement of various parameters

Remote hearing aid fitting: tele-audiology in the context of Brazilian Public Policy

INTRODUÇÃO: O governo brasileiro atualmente credencia cerca de 140 centros especializados para adaptações de aparelhos de amplificação sonora individual via SUS. Adaptações à distância através da internet podem permitir maior eficiência na prestação deste serviço e com maiores chances de aceitação por parte do paciente do SUS. OBJETIVOS: Descrever o caso de adaptação à distância realizado entre duas cidades, com revisão da literatura. MÉTODO: Equipamentos de informática e de tecnologia da informação, programador universal, aparelhos de amplificação sonora individual. ESTUDO DE CASO: Uma fonoaudióloga lotada num centro especializado introduziu a um centro remoto (distância de 200 km) um novo aparelho de amplificação sonora individual e seu programa de adaptação. O centro remoto assistiu a adaptação de dois pacientes em sua clínica, realizando voluntariamente a adaptação do terceiro paciente. Todo o procedimento foi realizado através da internet, contando com recursos de áudio e vídeo em todos os procedimentos. RESULTADOS: Três pacientes foram adaptados à distância. Três fonoaudiólogas receberam treinamento à distância de como adaptar aparelhos auditivos. CONCLUSÃO: Foi possível adaptar AASI à distância, além de prover treinamento e habilitar um centro remoto na adaptação de um novo aparelho de amplificação sonora individual e de seu programa de adaptação. Tal procedimento pode ser útil ao governo na condução de políticas públicas da saúde auditiva

Integration of multimetric path management into 802.11S for telemedicine quality of service provision

The merits of 802.11s as the wireless mesh network standard provide a low cost and high independent scalability telemedicine infrastructure. However, challenges in degradation of performance as hops increase and the absence of Quality of Service (QoS) provision need to be resolved. Reliability and timely manner are important factors for successful telemedicine service. This research investigates the use of 802.11s for telemedicine services. A new model of 802.11s based on telemedicine infrastructure has been developed for this purpose. A non deterministic polynomial path selection is proposed to provide end-to-end QoS provisioning in 802.11s. A multi-metric called QoS Price metric is proposed as measurement of link quality. The QoS Price is derived from multi layers values that reflect telemedicine traffic requirement and resource availability of the network. The proposed solution has modified the path management of 802.11s and added resource allocation in distributed scheme. This modification and resource allocation improvement of 802.11s were given the designation medQoS-802.11s. MedQoS- 802.11s could provide a link guarantee of telemedicine traffic transmission in the selected path. MedQoS-802.11s had been tested using ns3 simulation and real environment testbed. The result has shown that medQoS-802.11s could achieve the traffic guarantee for almost 95% telemedicine traffic with 58% for the resource intensive diagnostic video traffic. It has also shown that the cost of link path overhead is efficient with the transmission overhead having an increment of 6% compared to the original 802.11s. The concurrent connection results for single time transmission shows that medQoS-802.11s has a significant increase of up to 12% traffic than original 802.11s. The testbed results have verified the QoS guarantee of the intended telemedicine traffic per transmission time. In summary, the reliability and time guarantee of medQoS has highly improved 802.11s to transmit telemedicine traffic

Um sistema de telemedicina de baixo custo em larga escala

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Ciência da ComputaçãoA Telemedicina é um serviço baseado na utilização dos recursos de comunicação e informática visando fornecer auxilio médico à distância para um paciente, fornecendo ferramentas para que um médico especialista realize sua função sem que seja necessário o contato direto entre eles. Para que um sistema de telemedicina seja funcional e adequado, é necessário entender a necessidade operacional e técnica, assim como delimitar que tipos de recursos são importantes para que o médico execute adequadamente seu trabalho, mesmo estando distante de seu ambiente normal de trabalho. Apresentamos aqui um modelo de rede de telemedicina em larga escala voltado para a realização de laudos a distância de exames de radiologia e cardiologia de acordo com a realidade, necessidades e capacidades operacionais e funcionais identificadas para o Estado de Santa Catarina. Demonstramos a viabilidade da utilização da infra-estrutura de rede e aparelhagem médica computadorizada já instalada para diminuir os custos de deslocamento de pacientes e o tempo de espera para a realização do laudo dos exames médicos auxiliados por computador, agilizando o atendimento médico aos pacientes. Garantimos a segurança, o armazenamento e a correta visualização dos exames, através da utilização de protocolos e padrões utilizados internacionalmente

An inter-organization workflow management system for virtual enterprises

Master'sMASTER OF SCIENC

An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient's lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) a flexible telemedicine framework for the continuous upkeep o f patients' lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage o f patients' demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health JCT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/ final framework. The proposed framework may assist in achieving continual access to a patient's lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient's health history whenever required, even during the computer system's downtime and the unavailability of the landline telecommunication network