Case Study | www.itaniumsolutions.org
Itanium - based Servers at the Heart
®
of Kiwok Telemedicine Solution
Overview
Kiwok Nordic AB was founded in 2003 by Anders Björlin and Björn
Söderberg with one goal in mind: mobile monitoring of people
with heart diseases. Kiwok’s intelligent mobile communication
health-sensor system, called BodyKom Series™ ECG, is dramatically
improving the quality of healthcare for patients as well as saving
more than half of the costs incurred by conventional in-hospital
“ heItanium-basedHPNonStopplatform
T
monitoring systems.
ensuresthatinformationonmonitored
patientsiscompletelyreliableand Twenty-two million people in the western world suffer from
availableonaglobalbasis.” heart failures.1 Diagnosis and treatment drive unpredictable cost
— Björn Söderberg, founder and Sales
increases and staffing pressures on clinics and hospitals. The
and Marketing Director, Kiwok
cost of inefficient healthcare processes and incorrect diagnosis
is daunting: for example, 16 percent of hospital beds in Swedish
hospitals are occupied by incorrectly medicated heart patients.2
Anders Björlin experienced the challenge of heart disease
diagnosis first-hand when he started having cardiac fibrillations.
After disappointing results with existing monitoring products, he
asked his doctor for a means to monitor his heart more effectively,
over a longer period of time. No such solution existed, so Anders
and his colleagues devised one using technologies already on the
market. The result is BodyKom, a mobile monitoring solution
™
with extended ease of use, data quality and availability.

BodyKom Series ECG is a complete solution that remotely
monitors and collects ECG data from patients whose heart
conditions do not require hospitalization, yet require
periodic or frequent monitoring. By building on Sweden’s
excellent mobile telephone network, common remote
sensor devices, industry-standard servers and proprietary
software, Kiwok was able to connect the first patients to
the system in 2006. The company is now poised to roll the
service out to additional markets.
Monitoring, storing and providing access to critical health-
care data requires the utmost confidence in a remote
monitoring system. That’s why the heart of the BodyKom
solution is built on HP Integrity NonStop* servers with
Intel® Itanium® processors. They provide the reliability,
performance and scalability needed to advance the benefits
of telemedicine to doctors and patients worldwide.
“ elemedicineservicesingeneralandBodyKomSeries
T
ECGinparticularcanreducethecarecostofearly
stageheartfailurepatientsupto80%.”
- Anders Björlin, Founder and Business Architect, Kiwok Björn Söderberg, one of the founders of Kiwok,
wearing the BodyKom* sensors.
Challenges
In architecting BodyKom, the first priority was reliability –
an absolute requirement for the health sector. Because it
is impossible to predict when an important ECG event will
occur that may lead to an accurate diagnosis and effective
treatment for the patient, the BodyKom system had to work
around the clock, seven days a week, 365 days a year.
In addition to uptime, the solution needed outstanding avail-
ability to faithfully register every heartbeat. And as part of
the patient’s medical record, the ECG database had to be
completely secure. To evaluate the data, healthcare provid-
ers needed the data to be securely transferred to analysis
tools in a variety of hospital and clinic environments.
With tens of millions of heart patients worldwide, the
demand for this solution is considerable. The BodyKom
system has to scale seamlessly as it is rolled out to
different regions. The BodyKom* solution is based on existing, cost-effective
technologies that make it possible for Kiwok to deploy it
One final challenge for Kiwok was to clearly show the to patients worldwide.
cost benefits of this type of telemedicine solution to health
care providers and decision makers. The entire solution
needed to be based on existing, cost-effective technologies
Benefits of Itanium
that are easy to replicate for Kiwok to make BodyKom
Kiwok chose Itanium®-based HP Integrity NonStop*
available to patients worldwide.
servers for their reliability and scalability. The Integrity
servers ensure that heart monitoring information is
faithfully recorded and 100 percent accessible on a
global basis. These servers also have the required
levels of security to protect the integrity of both
patients and healthcare providers.
2 Case Study | Itanium®-based Servers at the Heart of Kiwok Telemedicine Solution

BodyKom* system elements
Solution
Kiwok developed and tested BodyKom in close cooperation Rules Engine
with Karolinska University Hospital and HP, starting in April The communication platform used by BodyKom*
2005. Using BodyKom, sensors attached to patients relay includes an intelligent rules engine with established
data to ECG equipment, which sends the data to a modified pre-programmed rules. The platform applies the rules
cell phone via Bluetooth. The cell phone regularly trans- selected by the patient’s doctor. This means that only
mits information to the BodyKom server, which checks the relevant requested data are sent to the care provider’s
data and notifies healthcare personnel if any irregularities application and the rules engine can eliminate unde-
occur. The doctors can then monitor the heart data in real sired “white noise.” This ensures more efficient analysis
time via the mobile connection. Should the patient require and monitoring for the care provider.
immediate assistance, the cell phone’s GPS can pinpoint the
patient’s location for medical personnel.
The five sensors attached to the patient’s body continu-
The BodyKom solution comprises software, hardware, data ously register the heart rhythm. Independent sources have
communications and processing elements: verified that the BodyKom solution is at least as accurate
• Sensor: The sensor is a CardioScout ECG monitor devel- as traditional tape-recording systems. If the heart rhythm
oped by PicoMed GmbH in Germany. Used together with varies and the situation becomes critical, the system can
standard ECG electrodes, it records two-channel ECG and automatically initiate appropriate actions.
transmits the data using Bluetooth technology. If needed,
the sensor saves the data on a memory card. Results
• Communicator: A SonyEricsson K660i GSM/Edge* Today, more than 250 patients have been diagnosed by
mobile phone communicates with the Kiwok server using using the BodyKom Series ECG. Currently, four hospitals in
BodyKom client software. Scandinavia are using the solution. Kiwok is now beginning
a global rollout focusing on new markets in Europe, India
• Wireless Application Gateway (WAG): The compressed and Canada. The initial results have proven that BodyKom
data sent by the Communicator is processed by WAG provides great advantages to healthcare providers, heart
Mobilis, a Java application from WIP in Sweden. The WAG patients and hospitals and clinics.
passes individual blocks of decompressed data to the
ShrtCut™ HUB. For healthcare providers, BodyKom Series ECG is making it
possible to monitor heart patients’ health conditions over
• ShrtCut HUB: ShrtCut HUB is a Java application running an extended period of time. By reading the heart rate over
on HP Integrity NonStop servers — the dual-core NS1200 — many days in a patient’s daily life, physicians receive the
based on the Intel Itanium processor. ShrtCut HUB best basis for diagnosis and treatment. This reduces the
receives and stores the decompressed data and then number of hospital visits and the amount of time needed
formats it for processing for ECG analysis. If it detects any to make the best diagnosis.
irregularities in the data (based on pre-defined condi-
tions), it alerts the healthcare provider and sends the data Patients using the BodyKom solution can continue to work
to the provider’s ECG analysis tools for further analysis or rest at home instead of interrupting their daily routines.
and action. They can count on a more accurate diagnosis and a greater
chance of receiving the best treatment for their conditions.
Case Study | Itanium®-based Servers at the Heart of Kiwok Telemedicine Solution 3

Challenges Results
Reliability is an absolute must in the healthcare sector. Itanium®-based NonStop* servers provide 24/7 uptime.
Unerring availability to register every heartbeat. Non-stop OS ensures maximum uptime.
Complete security of patient data in database and OS and HP adapter technology ensures data security.
transfer to physicians.
Ramp up easily and cost-effectively for worldwide Industry-standard Itanium-based architecture is highly
deployment. scalable and cost competitive.
Prove value of telemedicine for monitoring Hospitals can cut costs up to 50 percent; clinics can see
of heart disease patients. five times the number of patients.
For the hospitals and clinics, the BodyKom solution saves
money and resources by liberating hospital beds and
providing immediate feedback on the effects of ongoing
medical treatment. It lowers demands on existing equip-
ment and personnel, freeing up resources for more critical
care activities. In fact, by using ECG telemedicine service to
pass heart treatment to primary care centers, more than
25 percent of heart treatment care costs in major hospitals
can be rededicated to more advanced care efforts3 Remote
.
monitoring can reduce the number and duration of patient
visits while improving the results of treatment. Primary
care centers can diagnose five times more patients by using
BodyKom Series ECG telemedicine service without increasing
ECG data spanning several days provides the best basis
the staff.3
for diagnosis and treatment.
Itanium at the Heart
of Kiwok’s Solution
System Configuration
The success of BodyKom is well known in Sweden. For exam-
Hardware: HP Integrity NonStop* server, NS1200,
ple, BodyKom was featured in a TV production “Diagons
dual-core Itanium®-based server. 16 Mb of shared
Okänd” (“Diagnosis Unknown”), in which physicians used
memory, 8x144 GB of storage and a dual 3870-24
BodyKom to investigate heart conditions.
network connection.
Kiwok is now gaining the momentum and credentials to
Operating system: HP NonStop OS with modified
expand worldwide. The company has been mentioned in
version of HP Real Time Information Director (RTID);
Gartner research reports4 and has received several industry
Debian Linux* server (WAG).
awards. It has developed partnerships and representation
5
on three continents. And it can count on the reliability, Application: WAG Mobilis Java application, ShrtCut™
security, scalability and cost efficiency of industry-standard HUB Java application inmate management system.
Itanium-based servers. These are the reasons why Kiwok is
confident it can roll out BodyKom to healthcare providers,
and improve the treatment of heart patients around
the world.
1
IEEE Spectrum in December 2004, from the article “Managing Care through the air.”
2
Professor Christer Sylvén at the Karolinska University Hospital in Huddinge, Stockholm.
3
Source: “Care Process Economy” by Kiwok, please contact info@kiwok.com for a copy.
4
“Hype Cycle for Telemedicine,” June 25, 2008, and “Cool Vendors in Healthcare Providers,” March 27, 2009.
5
[Please provide citation to one or more awards.]
Copyright © 2009 Itanium Solutions Alliance. All rights reserved. Intel, the Intel logo, and Itanium are trademarks of Intel Corporation in the U.S. and other countries.
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Case Study | Itanium®-based Servers at the Heart of Kiwok Telemedicine Solution