2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Nicholas MacKinnon, Shanil Gunasekara, Fartash Vasefi...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Outline
• eTreat Mobile Health Approach
• Hand Arthri...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
eTreat Mobile Health
• Mobile apps and cloud computin...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Global Demand for Mobile Health Applications
• By 201...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
• App captures data from camera and sensors of phone
...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Specific Apps for Specific Conditions
• App provides ...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Secure Cloud Processing and EHR
• Every App has a clo...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
First Chronic Disease App – Hand Arthritis
• Common c...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview
 User log-in/registrati...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Procedure overview and Screenshots
 User l...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Image Processing :
Distortion removal
Spatial calibra...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
A
B
C
D A’ B’
C’D’
216mm
279 mm
ArthTrac: Distortion ...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Image processing identifies hand
– Image pr...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Boundary information is analyzed
• Boundary...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ϴ
ArthTrac: Features located on boundary data
– Fiduc...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
(1) (2)
(3) (4)
Analysis of Normal and Arthritic Hand...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
(1)
100 200 300 400 500 600
140
150
160
170
180
100 2...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
Analysis of Phalange Angular Deviation
• Normal Hand ...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com
ArthTrac: Secure Transfer to Servers and EHR
• Regula...
2014 CMBEC37 Conference
Vancouver, BC
May 21 – 23, 2014
etreatmd.com27
Conclusion
• eTreat is focusing on chronic disease ...
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Development of a mobile medical application for imaging and analysis of arthritis of the hand

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Development of a mobile medical application for imaging and analysis of arthritis of the hand:

Nicholas MacKinnon, Shanil Gunasekara, Fartash Vasefi

eTreat Medical Diagnostics Inc., Vancouver, BC, Canada

This project introduces a new smartphone and tablet deployable mobile medical application that utilizes device sensors, internet connectivity and cloud-based image processing to document and analyze physiological characteristics of hand arthritis. The application facilitates image capture and performs image processing that identifies hand fiduciary features and feature metrics to report and quantify the progress of arthritic disease. In addition to describing this process, we discuss the technical issues and regulatory challenges related to development and deployment of mobile medical applications with reference to the 2013 FDA Final Guidance on Mobile Medical applications, HIPA requirements, and compliance with the ISO/IEEE 11073-10201 Domain Information Model (DIM) standard for integration with personal or institutional health records.

Presented at The Canadian Medical and Biological Engineering Society Conference CMBEC 37 in Vancouver Canada May 21 2014

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Development of a mobile medical application for imaging and analysis of arthritis of the hand

  1. 1. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Nicholas MacKinnon, Shanil Gunasekara, Fartash Vasefi May 2014 ©2014 eTreat Medical Diagnostics Inc. www.etreatmd.com Corresponding author: nmackinnon@etreatmd.com DEVELOPMENT OF A MOBILE MEDICAL APPLICATION FOR IMAGING AND ANALYSIS OF ARTHRITIS OF THE HAND eTreat Medical Diagnostics Inc.
  2. 2. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Outline • eTreat Mobile Health Approach • Hand Arthritis • Image transfer and security • Image Analysis • Reporting and Tracking • Arthtrac Market 2
  3. 3. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com eTreat Mobile Health • Mobile apps and cloud computing to manage chronic health problems throughout the world
  4. 4. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Global Demand for Mobile Health Applications • By 2017 mobile health revenue to reach $23 billion • 70% will be chronic disease management. • eTreat is focused on apps directed to chronic diseases such as arthritis, diabetic ulcers, chronic wounds, skin conditions and muscular/skeletal disorders.
  5. 5. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com • App captures data from camera and sensors of phone • App captures user input from prompts • Data upload for analysis and cloud health record • Information and reports go to users, clinicians, etc. eTreat Mobile Health Concept
  6. 6. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Specific Apps for Specific Conditions • App provides a report like a lab test • Asks questions and logs data • Provides useful information and reminders to user • Info stored securely in cloud Electronic Health Record
  7. 7. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Secure Cloud Processing and EHR • Every App has a cloud processing engine and database • EHR captures and logs user encounters with App • Data and analyses captured by EHR • EHR is a full clinical record system ( HIPA, HL7 compliant) • Data owned by the user • Can send to medical practitioners and other EHR systems
  8. 8. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com First Chronic Disease App – Hand Arthritis • Common chronic health problem affecting articulating joints • Causes pain, deformity and moderate to severe disability. • Symptomatic OA has inflammatory episodes that result in joint swelling and tenderness • Irritation of nerves and blood vessels of synovial membrane (encapsulates and lubricates the joint) Disease Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific Population 857 939 605 899 1830 1808 Hand Arthritis 58 64 41 61 124 123 Foot Arthritis 54 59 38 57 115 114 Hand and Foot Arthritis Prevalence (millions) by WHO region, 2004 Radiographic Arthritis Symptomatic Arthritis
  9. 9. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  10. 10. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  11. 11. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  12. 12. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  13. 13. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  14. 14. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  15. 15. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  16. 16. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  17. 17. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Procedure overview and Screenshots  User log-in/registration  Instructions for image capture  Capture image of the subject hand on white letter/A4 size paper  Verify Image is OK  Send image to cloud for image analysis (patent pending method)  Store data to cloud electronic health record (EHR)  Receive processed image from cloud  Receive measurement data analysis report
  18. 18. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Image Processing : Distortion removal Spatial calibration Background removal Anatomical analysis 18
  19. 19. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com A B C D A’ B’ C’D’ 216mm 279 mm ArthTrac: Distortion correction and calibration –Letter/ A4 Paper is identified –Distortion is removed –Image is cropped and scaled
  20. 20. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Image processing identifies hand – Image processing software processes and segments image – Hand is separated from Background – The image is analyzed and converted to a binary format – The binary image is analyzed and the boundary determined 20 0 200 400 600 800 1000 1200 1400 1600 1800 400 600 800 1000 1200 1400 1600 1800 2000 20
  21. 21. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Boundary information is analyzed • Boundary image can now be analyzed to provide arthritis metrics • Analysis algorithm identifies key fiduciary feature coordinates • Tips and vertexes of fingers 21
  22. 22. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ϴ ArthTrac: Features located on boundary data – Fiduciary features of hand are now identified – Boundary image can now be analyzed to provide arthritis metrics – Distances, angles, widths can become features for analysis – From analysis can identify anatomical irregularities – Anatomical characteristics can be compared over time 22
  23. 23. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com (1) (2) (3) (4) Analysis of Normal and Arthritic Hand • Normal Hand • Osteoarthritic Hand (5) (6) (7) (8)
  24. 24. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com (1) 100 200 300 400 500 600 140 150 160 170 180 100 200 300 400 500 140 160 180 200 Finger #3 Thickness Finger #2 Thickness Analysis of Phalange Width
  25. 25. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com Analysis of Phalange Angular Deviation • Normal Hand • Osteoarthritic Hand
  26. 26. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com ArthTrac: Secure Transfer to Servers and EHR • Regulatory Compliance – HIPAA compliant to ensure confidentiality – CEN ISO/IEEE 11073 standard – HL7 compliant data to effectively interface with electronic health record – ISO 13485 / GMP compliant as medical device – Fingerprint blurring for additional security – Cloud based app and image processing server – Cloud based EHR database server 26
  27. 27. 2014 CMBEC37 Conference Vancouver, BC May 21 – 23, 2014 etreatmd.com27 Conclusion • eTreat is focusing on chronic disease apps for arthritis, diabetes, chronic wounds, skin conditions and muscular/skeletal disorders. • Our prototype of our first app for hand arthritis, using cloud image processing has been demonstrated • The scientific basis of our patent pending image analysis software has been described • Questions? Website: etreatmd.com Tel: 1+ 604.836.5482 nmackinnon@etreatmd.com

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