Im3 04 Technologische Uitdagingen Voor Cardiale Telemonitoring Peter De Cleyn

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Im3 04 Technologische Uitdagingen Voor Cardiale Telemonitoring Peter De Cleyn

  1. 1. Technologische uitdagingen voor cardiale telemonitoring Peter De Cleyn IBBT-PATS-UA
  2. 2. Outline  Introduction  Future technologies  Future measurements  Conclusions  Demo scenarios  Demo
  3. 3. Introduction - IM3 Future Technologies  Goal: study the usability of emerging technologies to create an end-to-end interactive medical mobile monitoring solution  Approach:  Theoretical studies and simulations  Proof of Concept
  4. 4. End-to-End System Secure communication
  5. 5. End-to-End System Secure communication Sensor Capture Measurement Data
  6. 6. End-to-End System Secure communication Processing Sensor Networking Capture Process Data Measurement and Transmit Data Over BAN
  7. 7. End-to-End System Secure communication Processing Processing Sensor Networking Networking Capture Process Data Process Data Measurement and Transmit and Transmit Data Over BAN Over BAN (n-steps)
  8. 8. End-to-End System Secure communication Processing Processing Processing Sensor Gateway Networking Networking (UI) Capture Process Data Process Data Process Data Measurement and Transmit and Transmit and Transmit Data Over BAN Over BAN Over WAN (n-steps)
  9. 9. End-to-End System Add/Remove processing algorithms Start/Stop processing Configure parameters Remotely over WAN (Re)Configure Gateway Secure communication Processing Processing Processing Sensor Gateway Networking Networking (UI) Capture Process Data Process Data Process Data Measurement and Transmit and Transmit and Transmit Data Over BAN Over BAN Over WAN (n-steps)
  10. 10. End-to-End System Add/Remove processing algorithms Start/Stop processing Configure parameters Remotely over WAN (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Capture Process Data Process Data Process Data Process Data, Measurement and Transmit and Transmit and Transmit Store Data Over BAN Over BAN Over WAN Notify (n-steps) Present (multi-user)
  11. 11. End-to-End System Add/Remove processing algorithms Start/Stop processing Configure parameters Remotely over WAN (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Capture Process Data Process Data Process Data Process Data, Measurement and Transmit and Transmit and Transmit Store Data Over BAN Over BAN Over WAN Notify (n-steps) Present (multi-user)
  12. 12. WBAN (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI On body transport of measurements
  13. 13. WBAN  WBANs are wireless, short range, low power, multihop networks, to transport collected medical data from the sensor to a central device  Its application in healthcare requires these networks to be reliable, having long lifetime and for all be secure.  A hardware and routing software combination achieves these goals:  NXP CoolFlux Technology:  Ultra Low Power DSP (10MHz, 9kB SRAM, 6kWord flash)  Magnetic Radio CPFSK 7-15 MHz, ~ 20cm distance (optimum)  Cidada: Tree based scheduling protocol to efficiently and reliable collect data within a WBAN
  14. 14. Medical hub (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Medical hub
  15. 15. Medical hub  The Medical hub collects data from the WBAN, performs a first processing and analysis and transmits the data to the back end.  The Medical hub is a collection of software components, algorithms and device drivers.  All these components can be remotely managed:  Transparent to the patient: no interaction or contact with technician needed  Patient does not need to come in  Software is platform independent: Same software runs on wide variety of smartphone, PDA or PC systems: applicable to existing devices  Software is lightweight: it must run smoothly on smallest platform
  16. 16. Medical hub – Web Services  Back end interaction using Web services  Goal: perfect interoperability between several service providers, by the use of distributed middleware  Web service =  Software application  Identified by a URI  Interfaces are defined, described, and discovered by XML artefacts (WSDL, UDDI)  Interactions with other software applications using XML-based messages via Internet-based protocols (SOAP)
  17. 17. Signal processing (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Processing of measurements
  18. 18. Signal processing  Huge amount of available information due to continuous monitoring  Automatic processing and event detection gives medical staff indication of problems  No need to review all date when no events are detected  Simplified algorithm at medical hub  False positives possible  Event processing at backend  False positives get removed
  19. 19. Signal processing  Performance of Atrium Fibrilation detector  Comparison of detections (blue) and scoring of cardiologist (green)
  20. 20. Security (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI End-to-End security
  21. 21. Security  Wireless communication medium  Appropriate security and privacy protection is necessary  Threat analysis: identification of security issues  Security requirements:  Confidentiality of medical data  Integrity of medical data  Source authentication of medical data  Mutual device authentication  (Location) privacy  End-to-end security  CICADA-S: secure version of WBAN protocol  Asymetric cryptography has interesting advantages but is energy consuming  Feasability study of elliptic curve cryptography on WBAN sensor
  22. 22. Data representation (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Data storage and representation
  23. 23. Data representation  Website :  Visualisation of the measurements  Download data file for further processing and analysis  Patient information and history  Event notification
  24. 24. Future measurements (Re)Configure Gateway Secure communication Processing Processing Processing Processing Sensor Gateway Storing Networking Networking (UI) Multiple UI Actual needed measurements
  25. 25. Future measurements  Objective:  Determine what measurements are important and economically feasible to include in Remote Patient Monitoring solutions for  Congestive Heart Failure  Atrial Fibrillation
  26. 26. Consolidation CHF  More types of measurements could provide more information, but:  Weight (mainly to determine increase in fluids)  Respiration (correlated to motion)  Both rhythm and volume  Heart beat and heart rate variability (with coupled motion/accelerometer) are sufficient to measure in telemonitoring.  Additional  Blood pressure  ECG  Lungimpedance  Note:  Other measurements will take place in the hospital  Full ECG not required, but HB and HRV can be derived from it  Measure fluids in lungs can be a measurement in telemonitoring  Should be automatic – no patient action. Can be impedance or sound.  BP and Weight will be done by the patient  ECG (HB/HRT) can be automatic and without patient interference if subcutaneous  Continuous measurement next to the daily BP and weight measurement
  27. 27. Consolidation AF  More types of measurements could provide more information, but:  ECG (with coupled motion/accelerometer) is sufficient to measure in telemonitoring.  Note:  ECG (HB/HRT) can be automatic and without patient interference if subcutaneous
  28. 28. Observations  Key: Weight (fluids), Respiration and Heart Beat (correlated to motion)  However  Measurements involve patient action which is not desired  Errors, discipline, patient stress  Sound/Impedance could replace weight measurements  For both fluids and respiration  For automatic measurement without patient action,  ECG  Sound and/or impedance  Motion can replace these – preferably subcutaneous – in the longer term
  29. 29. Conclusions  Technological factors which influence acceptance for an end-to-end telemonitoring system  ease of use for the patient  ease of (re)configuration and installation  accurate automatic data processing and filtering  data representation  overall security  Technology is currently available to tackle these needs!  Actual measurement needs should be defined for each pathology
  30. 30. Demo Scenario
  31. 31. Demo Scenario  WBAN  ECG transport  multihop routing  Medical HUB  remote configuration  signal processing  event detection  Backend  data retrieval  advanced signal processing
  32. 32. Demo Architecture

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