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Volume 20 | Issue 3
July 2020
Advances in
wireless
transmission
systems and signal
processing have
enabled researchers
to monitor vital
signs by analysing
characteristics of
wireless signals
that have reflected
off of the subject.
Viewpoint
Wireless Vital Signs Monitoring
of COVID-19 Patients
SUMMARY
The COVID-19 pandemic has generated an unprecedented health crisis world-wide. Remote
monitoring of COVID-19 patients is a crucial requirement since this enables continuous patient
monitoring without compromising the safety of the health care provider. Remote monitoring
using wearables can be obtrusive and uncomfortable for the user, especially when used for long
periods of time. Advances in wireless transmission systems and signal processing have enabled
researchers to monitor vital signs by analysing characteristics of wireless signals that have
reflected off of the subject. Wireless signals for sensing vital signs has been developed since
2015 but there are still significant challenges to be overcome. One of the challenges in using
wireless signals to monitor vital signs is that any motion in the environment affects the signal.
Furthermore, the presence of multiple users prevents systems from operating error free, even if
the users are stationary.
The key player in the wireless vital signs monitoring is MIT’s Emerald Innovations with its
wireless sensing technology that monitors breathing and heart rate without body contact. Another
player is Origin Wireless with its Origin Health, that enables accurate respiratory, monitoring at
home without intrusive wearables. ResMed and Microsoft/University of Washington are other
players that have developed wireless vital signs monitoring technology. But they do not seem to
be commercializing their technology for COVID-19. Though there are some developments in
wireless vital signs technology, there are significant opportunities for other players to innovate.
Interference, Patient Movements and multiple user differentiation are some of the problems that
need to be addressed to improve the accuracy and sensitivity. The remote vital signs monitoring
market is projected to reach US$31.326 billion by the end of 2023 and will become increasingly
important and ubiquitous.
BACKGROUND
The remote patient monitoring market is expected to reach US$31.326 billion by the end of 2023,
increasing from US$15.871 billion in 2017, growing at a CAGR of 12% during the forecast
period. Remote patient monitoring makes use of digital technologies to collect medical and
various other forms of health data and transmit them to a healthcare provider. The data can be
collected at patient’s residence, thus avoiding visits to the hospital/clinic, also reducing risk for
both doctors and patients. The market for remote patient monitoring is expected to grow even
more significantly in the wake of the current COVID-19 pandemic.
The COVID-19 pandemic has generated an unprecedented health crisis world-wide. One of the
challenges is remote monitoring of COVID-19 patients either in a hospital or home setting.
Periodic vital signs monitoring of COVID-19 patients is very crucial and remote monitoring
minimizes risks for healthcare providers including doctors and nurses. The four main vital signs
routinely monitored are body temperature, pulse rate, respiration rate and blood pressure.
Technology
2
Wearable systems
can be obtrusive
and uncomfortable
for the user,
especially when
used for long
periods of time.
Most conventional telemonitoring systems employ wearable sensors that measure bodily
parameters that are then used to determine the user vital signs. For example, Caretaker Medical,
announced Australia’s first ‘virtual hospital. This solution uses a wearable device and AI to
assist doctors to remotely monitor COVID-19 patients in their homes. Another example is the
cosinuss°system that uses wearable sensors to detect, analyse and transmit information
concerning vital signs, and ambient data which allow immediate biofeedback to the wearer
and/or to remote operators in healthcare.
Wearable systems can be obtrusive and uncomfortable for the user, especially when used for
long periods of time. As a result, non-contact technologies to monitor vital signs have been
developing over the last 5 years even before the present COVID-19 crisis.
Non-contact measuring techniques propose the use of electromagnetic signals including
radiofrequency (RF), microwave, radar, light, wireless signals, imaging techniques, non-contact
sensors including IR, vibration and pressure sensors. Each technique has its merits and
shortcomings. For example, imaging systems raise privacy concerns, electromagnetic signals
cause safety concerns. In this study, we focus on the use of wireless signals for vital signs
monitoring.
Advances in wireless transmission systems and signal processing have enabled researchers to
monitor vital signs by analysing characteristics of wireless signals that get reflected off of the
subject. One challenge in using wireless signals to monitor vital signs is that any motion in the
environment affects the signal. Since breathing and heartbeats are minute movements, it can be
easily masked by interference from any other source of movement in the environment.
Furthermore, the presence of multiple users, even if the users are stationary, prevents systems
from operating correctly since the wireless signal is affected by the combination of their vital
signs, making it difficult to distinguish the vital signs of each individual.
MIT CSAIL
MIT has made immense progress in the wireless vital signs monitoring technology space. MIT’s
Computer Science and Artificial Intelligence Laboratory (CSAIL) has developed Vital-Radio,
a wireless sensing technology that monitors breathing and heart rate without body contact. Vital-
Radio exploits the fact that wireless signals are affected by motion in the environment, including
chest movements due to inhaling and exhaling and skin vibrations due to heartbeats. It analyses
the surrounding radio signals using signal processing and neural networks, and infers people's
movements, breathing, heart rate, falls, sleep apnoea, and sleep stages -- all in a touchless
manner without requiring users to wear any sensors or change their behaviour in any way as
they go about their lives. It provides continuous health data and predictive analyses to doctors,
researchers, pharmaceutical companies, assisted living homes and caregivers, and health
insurers. One user study claims that this device can track users’ breathing and heart rates with a
median accuracy of 99%, even when users are 8 meters away from the device, or in a different
room. Furthermore, it can monitor the vital signs of multiple people simultaneously.
3
The research at CSAIL has resulted in yet another MIT spin-off out of Cambridge, Emerald
Innovations. Emerald was founded in 2016 by a team of MIT faculty and graduate students
and focusses on completely contactless and passive health monitoring. Emerald’s solution is
found to useful for the current COVID-19 pandemic as it enables doctors to monitor patients
from a safe distance. The CSAIL team has already put Emerald to use at an assisted living
facility, it was used for remotely monitor a COVID-19 patient.
MIT has been protecting their intellectual property and started filing patent applications from
2015. MIT’s strategy is to obtain patent protection in key markets, Europe, Japan, China and
the US. Patent Application WO2015168093-Vital Signs Monitoring Via Radio Reflections is
filed in Europe, Japan, China and the US but has not been granted in any region yet.
MIT has filed a set of related applications for wireless sensing of physiological signals. The
patent application WO2018013192 discloses detection of emotional state; patent application
WO2018183106 discloses detection of sleep stages; WO2019191537 discloses pose
estimation, patent application US20200155038 discloses monitoring of a patient undergoing
therapy – all of them use wireless sensing. US9753131 is a granted patent to MIT for motion
tracking via body radio reflections.
ORIGIN WIRELESS
Origin delivers Wireless Artificial Intelligence for Smart Life by developing advanced
wireless sensing technologies for a wide range of applications, including indoor positioning
systems, motion sensing, breathing/sleep monitoring, and fall detection solutions. The
company has three core product lines - Origin Home, Origin Health, and Origin Tracking -
target smart homes, cars, buildings, and factories, with use-cases in security monitoring,
asset/people tracking, and elderly well-being monitoring. Origin Health enables accurate
respiratory, sleep, and fall monitoring that detects activity without intrusive wearables or
cameras, ensuring peace of mind when caring for loved ones.
4
The company’s technology is based on patented wireless AI algorithms that leverage multipath
propagation of Wi-Fi signals. This leads to improved resolution of indoor sensing and
positioning by leveraging the physical phenomenon of Time Reversal theory
Origin Wireless has filed four patent applications related to this technology. EP3426137 filed
in 2016 relates to vital sign detection and monitoring based on channel state information of
wireless channels. The patent application EP3492945 discloses a system for periodic motion
detection and monitoring in a venue based on time-reversal technology. US2019166030
discloses a related system for detecting and monitoring vital signs and other periodic motions
in a venue. US10495725 is a patent granted to Origin Wireless for wireless real-time vital
sign detection and monitoring
MICROSOFT AND UNIVERSITY OF WASHINGTON
Wibreathe has been developed by University of Washington in collaboration with Microsoft in
2015 to estimate respiration rate using wireless signals in natural settings in the home.
WiBreathe is a wireless, high fidelity and non-invasive breathing monitor that leverages
wireless signals at 2.4 GHz to estimate an individual’s respiration rate. The system uses a single
transmitter-receiver pair at the same frequency range of commodity Wi-Fi signals to estimate
the respiratory rate of an individual. This is done irrespective of whether they are in line of
sight or not (e.g., through walls).
5
Wireless-signal
based vital signs
monitoring is
envisioned to be
an emerging
crucial technology
that avoids
unnecessary
hospital visits for
the patient at the
same time
minimizing risks
for healthcare.
The Wibreathe system was tested in both a lab-controlled and real home environment. The
results show an average error rate of 2.16 bpm in a natural setting across our 6 participants,
which is comparable to a clinical breathing monitor. As health sensing becomes more
commonplace, WiBreathe enables whole-home, continuously respiratory rate monitoring,
obviating the need for any wearables on the body.
Microsoft’s Healthcare strategy is centred on new cloud and Artificial Intelligence products
for hospitals. Microsoft has several initiatives for fighting COVID-19. These initiatives
include the COVID-19 High Performance Computing Consortium, a private-public effort
spearheaded by the White House and The Institute for Health Metrics and Evaluation
(IHME), a global health research organization. However, the company has not mentioned
any commercialization of the Wibreathe technology. University of Washington also has not
yet commercialized their technology.
RESMED
ResMed, a leader in Respiratory Medicine, has developed a technology for non-contact
measurement of cardiorespiratory parameters. It has filed a patent EP2078270 that discloses
a method for monitoring motion, breathing, heart rate and for deriving and displaying
measurements of cardiorespiratory performance from said signals. The signals are obtained
through a processing applied to a raw signal obtained in a non-contact fashion, typically
using a radio-frequency sensor. Their solution also includes a second embodiments with
wearables. US9526429 is a granted patent to ResMed that discloses the use of transmitted
radio wave reflections to monitor a person’s vital signs. ResMed has not yet commercialized
this technology. ResMed’s COVID-19 efforts are focused on developing ventilators and
cloud-based remote monitoring solutions for ventilators.
OTHERS
US10264996 is a granted patent in April 2020 held by an individual inventor. This discloses
a method for wirelessly monitoring repetitive bodily movements to calculate respiration and
heart rate.
CONCLUSION
Wireless-signal based vital signs monitoring is envisioned to be an emerging crucial
technology that avoids unnecessary hospital visits for the patient at the same time
minimizing risks for healthcare. This technology is especially useful for pandemic situation
such as the current COVID-19 that requires continuous monitoring of patient vital signs.
The key player is MIT’s Emerald Innovations with its wireless sensing technology that
monitors breathing and heart rate without body contact. The MIT CSAIL team has already
put Emerald to use at an assisted living facility, where it was used to remotely monitor a
COVID-19 patient. Origin Health, the product from Origin Wireless enables accurate
respiratory, monitoring at home without intrusive wearables and is also a promising solution
to monitor COVID-19 patients from the comfort of their homes.
ResMed and Microsoft/Univ of Washington are other players that have developed wireless
vital signs monitoring technology. But it has not made progress in commercializing their
technology for COVID-19. ResMed focusses on it’s main ventilator product solutions for
Covid-19 whereas Microsoft has several initiatives for fighting COVID-19 but it does not
seem to be focusing on commercialization of its Wibreathe technology.
However, wireless vital signs monitoring technology is still maturing and there are
significant technical challenges and opportunities. One problem is detecting the respiration
rate when the user is not in LOS (Line Of Sight), e.g., through walls. Body movements and
posture can cause disruptions in signal strength. Distance between the patient and RF source
could also cause errors. Interference can be caused by any motion in the environment. When
there are multiple users, it can be difficult to distinguish the vital signs of each user.
Improved accuracy and sensitivity are still needed before these systems can be put to use in
actual healthcare setting.
6
Innomantra Consulting Private Limited
Level 9, Raheja Towers
M.G. Road, Bengaluru - 560 001, India
Mobile: +91 98452 72555
+91 080 41253444
contact@innomantra.com
www.innomantra.com
Bangalore / Mysore / Colombo / Chicago / Hong Kong / Troy / Zurich
©2015-20 Innomantra Consulting Private Limited –Viewpoint Ver. 1.0 F July 2020
Srividhya Easwaran ( Vidhya )
Principal - Intellectual Property Research & Innovation
vidhya@innomantra.com / contact@innomantra.com

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Innomantra viewpoint vital sign monitors covid 19 v1.0FF July 2020

  • 1. 1 Volume 20 | Issue 3 July 2020 Advances in wireless transmission systems and signal processing have enabled researchers to monitor vital signs by analysing characteristics of wireless signals that have reflected off of the subject. Viewpoint Wireless Vital Signs Monitoring of COVID-19 Patients SUMMARY The COVID-19 pandemic has generated an unprecedented health crisis world-wide. Remote monitoring of COVID-19 patients is a crucial requirement since this enables continuous patient monitoring without compromising the safety of the health care provider. Remote monitoring using wearables can be obtrusive and uncomfortable for the user, especially when used for long periods of time. Advances in wireless transmission systems and signal processing have enabled researchers to monitor vital signs by analysing characteristics of wireless signals that have reflected off of the subject. Wireless signals for sensing vital signs has been developed since 2015 but there are still significant challenges to be overcome. One of the challenges in using wireless signals to monitor vital signs is that any motion in the environment affects the signal. Furthermore, the presence of multiple users prevents systems from operating error free, even if the users are stationary. The key player in the wireless vital signs monitoring is MIT’s Emerald Innovations with its wireless sensing technology that monitors breathing and heart rate without body contact. Another player is Origin Wireless with its Origin Health, that enables accurate respiratory, monitoring at home without intrusive wearables. ResMed and Microsoft/University of Washington are other players that have developed wireless vital signs monitoring technology. But they do not seem to be commercializing their technology for COVID-19. Though there are some developments in wireless vital signs technology, there are significant opportunities for other players to innovate. Interference, Patient Movements and multiple user differentiation are some of the problems that need to be addressed to improve the accuracy and sensitivity. The remote vital signs monitoring market is projected to reach US$31.326 billion by the end of 2023 and will become increasingly important and ubiquitous. BACKGROUND The remote patient monitoring market is expected to reach US$31.326 billion by the end of 2023, increasing from US$15.871 billion in 2017, growing at a CAGR of 12% during the forecast period. Remote patient monitoring makes use of digital technologies to collect medical and various other forms of health data and transmit them to a healthcare provider. The data can be collected at patient’s residence, thus avoiding visits to the hospital/clinic, also reducing risk for both doctors and patients. The market for remote patient monitoring is expected to grow even more significantly in the wake of the current COVID-19 pandemic. The COVID-19 pandemic has generated an unprecedented health crisis world-wide. One of the challenges is remote monitoring of COVID-19 patients either in a hospital or home setting. Periodic vital signs monitoring of COVID-19 patients is very crucial and remote monitoring minimizes risks for healthcare providers including doctors and nurses. The four main vital signs routinely monitored are body temperature, pulse rate, respiration rate and blood pressure. Technology
  • 2. 2 Wearable systems can be obtrusive and uncomfortable for the user, especially when used for long periods of time. Most conventional telemonitoring systems employ wearable sensors that measure bodily parameters that are then used to determine the user vital signs. For example, Caretaker Medical, announced Australia’s first ‘virtual hospital. This solution uses a wearable device and AI to assist doctors to remotely monitor COVID-19 patients in their homes. Another example is the cosinuss°system that uses wearable sensors to detect, analyse and transmit information concerning vital signs, and ambient data which allow immediate biofeedback to the wearer and/or to remote operators in healthcare. Wearable systems can be obtrusive and uncomfortable for the user, especially when used for long periods of time. As a result, non-contact technologies to monitor vital signs have been developing over the last 5 years even before the present COVID-19 crisis. Non-contact measuring techniques propose the use of electromagnetic signals including radiofrequency (RF), microwave, radar, light, wireless signals, imaging techniques, non-contact sensors including IR, vibration and pressure sensors. Each technique has its merits and shortcomings. For example, imaging systems raise privacy concerns, electromagnetic signals cause safety concerns. In this study, we focus on the use of wireless signals for vital signs monitoring. Advances in wireless transmission systems and signal processing have enabled researchers to monitor vital signs by analysing characteristics of wireless signals that get reflected off of the subject. One challenge in using wireless signals to monitor vital signs is that any motion in the environment affects the signal. Since breathing and heartbeats are minute movements, it can be easily masked by interference from any other source of movement in the environment. Furthermore, the presence of multiple users, even if the users are stationary, prevents systems from operating correctly since the wireless signal is affected by the combination of their vital signs, making it difficult to distinguish the vital signs of each individual. MIT CSAIL MIT has made immense progress in the wireless vital signs monitoring technology space. MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) has developed Vital-Radio, a wireless sensing technology that monitors breathing and heart rate without body contact. Vital- Radio exploits the fact that wireless signals are affected by motion in the environment, including chest movements due to inhaling and exhaling and skin vibrations due to heartbeats. It analyses the surrounding radio signals using signal processing and neural networks, and infers people's movements, breathing, heart rate, falls, sleep apnoea, and sleep stages -- all in a touchless manner without requiring users to wear any sensors or change their behaviour in any way as they go about their lives. It provides continuous health data and predictive analyses to doctors, researchers, pharmaceutical companies, assisted living homes and caregivers, and health insurers. One user study claims that this device can track users’ breathing and heart rates with a median accuracy of 99%, even when users are 8 meters away from the device, or in a different room. Furthermore, it can monitor the vital signs of multiple people simultaneously.
  • 3. 3 The research at CSAIL has resulted in yet another MIT spin-off out of Cambridge, Emerald Innovations. Emerald was founded in 2016 by a team of MIT faculty and graduate students and focusses on completely contactless and passive health monitoring. Emerald’s solution is found to useful for the current COVID-19 pandemic as it enables doctors to monitor patients from a safe distance. The CSAIL team has already put Emerald to use at an assisted living facility, it was used for remotely monitor a COVID-19 patient. MIT has been protecting their intellectual property and started filing patent applications from 2015. MIT’s strategy is to obtain patent protection in key markets, Europe, Japan, China and the US. Patent Application WO2015168093-Vital Signs Monitoring Via Radio Reflections is filed in Europe, Japan, China and the US but has not been granted in any region yet. MIT has filed a set of related applications for wireless sensing of physiological signals. The patent application WO2018013192 discloses detection of emotional state; patent application WO2018183106 discloses detection of sleep stages; WO2019191537 discloses pose estimation, patent application US20200155038 discloses monitoring of a patient undergoing therapy – all of them use wireless sensing. US9753131 is a granted patent to MIT for motion tracking via body radio reflections. ORIGIN WIRELESS Origin delivers Wireless Artificial Intelligence for Smart Life by developing advanced wireless sensing technologies for a wide range of applications, including indoor positioning systems, motion sensing, breathing/sleep monitoring, and fall detection solutions. The company has three core product lines - Origin Home, Origin Health, and Origin Tracking - target smart homes, cars, buildings, and factories, with use-cases in security monitoring, asset/people tracking, and elderly well-being monitoring. Origin Health enables accurate respiratory, sleep, and fall monitoring that detects activity without intrusive wearables or cameras, ensuring peace of mind when caring for loved ones.
  • 4. 4 The company’s technology is based on patented wireless AI algorithms that leverage multipath propagation of Wi-Fi signals. This leads to improved resolution of indoor sensing and positioning by leveraging the physical phenomenon of Time Reversal theory Origin Wireless has filed four patent applications related to this technology. EP3426137 filed in 2016 relates to vital sign detection and monitoring based on channel state information of wireless channels. The patent application EP3492945 discloses a system for periodic motion detection and monitoring in a venue based on time-reversal technology. US2019166030 discloses a related system for detecting and monitoring vital signs and other periodic motions in a venue. US10495725 is a patent granted to Origin Wireless for wireless real-time vital sign detection and monitoring MICROSOFT AND UNIVERSITY OF WASHINGTON Wibreathe has been developed by University of Washington in collaboration with Microsoft in 2015 to estimate respiration rate using wireless signals in natural settings in the home. WiBreathe is a wireless, high fidelity and non-invasive breathing monitor that leverages wireless signals at 2.4 GHz to estimate an individual’s respiration rate. The system uses a single transmitter-receiver pair at the same frequency range of commodity Wi-Fi signals to estimate the respiratory rate of an individual. This is done irrespective of whether they are in line of sight or not (e.g., through walls).
  • 5. 5 Wireless-signal based vital signs monitoring is envisioned to be an emerging crucial technology that avoids unnecessary hospital visits for the patient at the same time minimizing risks for healthcare. The Wibreathe system was tested in both a lab-controlled and real home environment. The results show an average error rate of 2.16 bpm in a natural setting across our 6 participants, which is comparable to a clinical breathing monitor. As health sensing becomes more commonplace, WiBreathe enables whole-home, continuously respiratory rate monitoring, obviating the need for any wearables on the body. Microsoft’s Healthcare strategy is centred on new cloud and Artificial Intelligence products for hospitals. Microsoft has several initiatives for fighting COVID-19. These initiatives include the COVID-19 High Performance Computing Consortium, a private-public effort spearheaded by the White House and The Institute for Health Metrics and Evaluation (IHME), a global health research organization. However, the company has not mentioned any commercialization of the Wibreathe technology. University of Washington also has not yet commercialized their technology. RESMED ResMed, a leader in Respiratory Medicine, has developed a technology for non-contact measurement of cardiorespiratory parameters. It has filed a patent EP2078270 that discloses a method for monitoring motion, breathing, heart rate and for deriving and displaying measurements of cardiorespiratory performance from said signals. The signals are obtained through a processing applied to a raw signal obtained in a non-contact fashion, typically using a radio-frequency sensor. Their solution also includes a second embodiments with wearables. US9526429 is a granted patent to ResMed that discloses the use of transmitted radio wave reflections to monitor a person’s vital signs. ResMed has not yet commercialized this technology. ResMed’s COVID-19 efforts are focused on developing ventilators and cloud-based remote monitoring solutions for ventilators. OTHERS US10264996 is a granted patent in April 2020 held by an individual inventor. This discloses a method for wirelessly monitoring repetitive bodily movements to calculate respiration and heart rate. CONCLUSION Wireless-signal based vital signs monitoring is envisioned to be an emerging crucial technology that avoids unnecessary hospital visits for the patient at the same time minimizing risks for healthcare. This technology is especially useful for pandemic situation such as the current COVID-19 that requires continuous monitoring of patient vital signs. The key player is MIT’s Emerald Innovations with its wireless sensing technology that monitors breathing and heart rate without body contact. The MIT CSAIL team has already put Emerald to use at an assisted living facility, where it was used to remotely monitor a COVID-19 patient. Origin Health, the product from Origin Wireless enables accurate respiratory, monitoring at home without intrusive wearables and is also a promising solution to monitor COVID-19 patients from the comfort of their homes. ResMed and Microsoft/Univ of Washington are other players that have developed wireless vital signs monitoring technology. But it has not made progress in commercializing their technology for COVID-19. ResMed focusses on it’s main ventilator product solutions for Covid-19 whereas Microsoft has several initiatives for fighting COVID-19 but it does not seem to be focusing on commercialization of its Wibreathe technology. However, wireless vital signs monitoring technology is still maturing and there are significant technical challenges and opportunities. One problem is detecting the respiration rate when the user is not in LOS (Line Of Sight), e.g., through walls. Body movements and posture can cause disruptions in signal strength. Distance between the patient and RF source could also cause errors. Interference can be caused by any motion in the environment. When there are multiple users, it can be difficult to distinguish the vital signs of each user. Improved accuracy and sensitivity are still needed before these systems can be put to use in actual healthcare setting.
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