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Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
DOI: 10.5121/hiij.2014.3302 9
SMART HOSPITAL TECHNOLOGY
1
M J Jayashree ,2
Aju Sam Sunny, 3
Anu John, 4
Ashley Anna Sunny, 5
Sruthi Susan
Sam.
Department of Electronics & Communication Engineering,Mar Baselios College of
Engineering and Technology,Mar IvaniosVidya Nagar, Bethany Hills , Nalanchira
Thiruvananthapuram -15, Kerala, India
ABSTRACT
The ECG signals captured from the body of the patient using three electrode model is processed and
conditioned by the analog front end device is finally sent to the data acquisition unit. The data acquisition
unit used is the user pc/ laptop with MATLAB. Using very specific image processing techniques the critical
intelligence from the captured image is extracted. From this processed image any sort of abnormal
conditions is determined which is informed to the corresponding doctor via text message. Simultaneously
the processed image is sent to the doctor mail by using specific TCP/IP protocol.
KEYWORDS
DFT, FFT, IFFT, LPF, Arduino
I. INTRODUCTION
In Telemedicine communication through audio and video is done to convey or exchange the
details of a patient with a physician. Using this process the details of a patient can also be
discussed and analysed. In health information technology Telemedicine plays a major role.
Telemedicine is basically the combination of medicine & information technology. This involves
the transmission of medical information electronically. Hence this can be used for conveying the
condition and status of patient to a doctor if the doctor is not available near the patient. Different
methods can be applied for this purpose For example: store-and-forward technology, secure
messaging; e-mailing,
By monitoring the data received, the doctor is able to understand the patient's condition, to
diagnose the disease and to take remedial measures. Videoconference is an effective measure in
this case.
2. TELE MONITORING
Tele monitoring is the monitoring patients who are not at the same location as the doctor. For
example consider a patient with monitoring devices at home. He can easily transmit the results
of to the doctor through telephone. This assists the patient to perform the initial and basic stage
of health care by himself. Also this avoids the un necessary travel by the patient. Tele medicine
is a fast growing field. A new type of Tele monitoring known as primary remote diagnostic
disease has been introduced in a number of developing countries. In this technique devices are
used by the doctor for the examination, diagnosis and treatment remotely. This type of treatment
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
10
is mainly used for monitoring the chronic diseases which have been diagnosed already. But this
new technology can also be applied for monitoring and diagnosing the common diseases such as
blood pressure, blood glucose, heart rate, weight etc. Frequent monitoring of the patient's
condition enables the physician to suggest the best and effective course of treatment to the
patient.
3. COMPONENTS OF THE SYSTEM
The system comprises of signal acquisition unit, processing unit and alerting system. The signal
acquisition unit is the high precision analog front end IC named AD620A from Analog devices. It
is a low cost, high accuracy instrumentation amplifier that requires only one external resistor to
set gains from 1 to 1000. The low noise, low input bias current and low power of the AD620
make it well suited for medical applications such as ECG and non-invasive blood pressure
monitors.
For the simulation of the below mentioned image processing algorithm, we use ECG signal
which is captured from the body in real time. The processing unit is coupled with a PIC micro
controller which acts as the alerting system. Data processing unit comprises of user PC / Laptop
loaded with MATLAB.
4. IMAGE PROCESSING
The atrial or ventricular regularity or irregularity is a measure of the cardiac rhythm which in turn
gives an idea about the regularity or irregularity of the heart beat. The consistency of patterns
between the p waves accesses atrial regularity while the consistency of patterns between R waves
accesses ventricular regularity. Typical ECG waveform is shown in Fig.No.1
Fig.No.1: Typical ECG waveform
Initially eyeballing, the rhythm for regularity was used. Now two more methods are available,
one is the use of callipers and the other is paper technique. In Callipers two needle points are
hinged together , one placed at the peak of the P wave or R wave and the other placed at the peak
of the subsequent P wave or R wave. The needle points are held steadily and the callipers are
moved down the strip. The needle points of the calliper if fall at the peaks of the subsequent P
waves shows atrial regularity. If the needle point falls on the peaks other subsequent R waves
shows ventricular regularity. On the other hand if the needle point do not fall at the peaks of the P
waves or R waves shows atrial and ventricular irregularities respectively.
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
11
In paper technique a clean and straight edge of paper is lined up with the peak of the P waves or
R waves. Three P wave peaks in a row are marked on the edge of the paper and the paper is then
moved to three subsequent P wave peaks. If the initial marks match with the marks of the
subsequent P waves that shows atrial regularity and if there is no matching between the marks it
shows atrial irregularity. Similarly ventricular regularity or irregularity is determined by
repeating the process with Rwaves.
5. IMPLEMENTATION ALGORITHM
Fig.No.2 Block diagram of Algorithm
Step1:
Obtain ECG signal from the controller, which is in digital form. The digital values obtained in the
controller is collected in MATLAB software in real time.
Step 2:
Apply smooth filtering process to remove higher frequencies. The most randomly occurring
signals are eliminated by setting a threshold value. These high frequency signals do not
contribute any intelligence. It may be due to loose contacts in the electrode or variations in
impedance matching.
Step 3:
To extract vital information from the ecg image apply wavelet decomposition technique.It is done
by using the function ‘wavedec’.
Step 4:
Set a threshold value for identifying the critical condition in heart beat rate using the relation
(maximum value-mean value) / 2.
Step 5:
R peak detection: Done using the function ‘waverec’, inverse of ‘wavedec’, which performs a
multilevel one dimensional wavelet reconstruction.
Step6:
If the adjacent peak distance is greater than a specific value, save the corresponding image to a
particular location in the computer.
Step7:
Calculate heart beat rate.
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
12
From the final detected peaks any sort of abnormality can be easily detected. In case of
emergency the PIC controller is triggered and the status of the patient is sent to the doctor as text
message using a GSM modem as shown in the block diagram given below.
Fig No 3. Block diagram representation of emergency alerting system
6. SIMULATION RESULTS
The setup is as shown in the Fig No.4
Fig No 4. The system
Health Informatics-A
Fig No.6
7. EMERGENCY ALERTING
The extracted vital intelligence in case of emergency is uploaded to the server. The image which
is now saved in the server is automatically sent to the mail
An International Journal (HIIJ) Vol.3, No.3,August 2014
Fig No 5 Final detected peaks
Fig No.6.Screen shot of message on doctor’s handset
LERTING SYSTEM
The extracted vital intelligence in case of emergency is uploaded to the server. The image which
is now saved in the server is automatically sent to the mail address of the doctors. In case of
13
The extracted vital intelligence in case of emergency is uploaded to the server. The image which
the doctors. In case of
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
14
emergency the trigger is given to PIC controller which will send text message to the doctor
using GSM modem. From the server the critical ECG image is sent to doctor’s email address.
For the website creation Microsoft Visual Studio 2010 is the IDE been used .The programming
language used here is C#.
Fig No.7.Login page of website
Fig.No.8.ECG results of various patients.
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
15
Fig No.9.List of doctors
Fig.No.10.ECG image of patient displayed
Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014
16
8. CONCLUSION
This system is an initiative of automation in critical health care management. It provides
continuous monitoring of patient and allows automatic data transfer. The system facilitates
equitable access to the specialists for all patients regardless of their location. It provides
opportunities for patients and relatives to contact their specialist. The system can completely
automate the medical emergency conditions happening in an ICU.
ACKNOWLEDMENT
The authors would like to thank their colleagues at Mar Baselios College of Engineering and
Technology for valuable discussions and feedback, also the reviewers for their
constructive comments.
REFERENCES
[1]Lai Khin Wee, Yeo KeeJiar, EkoSupriyanto “Electrocardiogram Data Capturing System and
Computerized Digitization using Image Processing Techniques” International Journal of Biology and
Biomedical Engineering Issue 3, Volume 3, 2009 .
[2]LjupˇcoHadˇzievski, BoˇskoBojovic´, VladanVukˇcevic´, PetarBeliˇcev, SiniˇsaPavlovic´,
ZoranaVasiljevic´-Pokrajˇcic´, and MiodragOstojic´’A Novel Mobile Transtelephonic System With
Synthesized 12-Lead ECG’ IEEE Transaction on Information Technology in Biomedicine,
Volume 8, 2004 .
[3]Prof. Dr. Burkhard Stiller ’Mobile Healthcare on Android Devices‟ Communication Systems Group,
Diploma Thesis, Dept. of Informatics, November 2010 .
[4]Karen Panetta, Yicong Zhou,SosAgaian,HongweiJia”Non linearunsharp masking for mammogram
enhancement” , IEEE Transaction on Information Technology in Biomedicine Volume. 15,
November 2011.
[5]Al-Naima, F. M., A. H. Ali, and S. S. Mahdi. "Data acquisition for myocardial infarction
classification based on wavelets and Neural Networks." Systems, Signals and Devices, 2008.
IEEE SSD 2008.5th International Multi-Conference on.IEEE, 2008.
[6]Chagas, A. V., E. A. B. Da Silva, and J. Nadal. "ECG data compression using wavelets." Computers in
Cardiology 2000.IEEE, 2000.

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SMART HOSPITAL TECHNOLOGY

  • 1. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 DOI: 10.5121/hiij.2014.3302 9 SMART HOSPITAL TECHNOLOGY 1 M J Jayashree ,2 Aju Sam Sunny, 3 Anu John, 4 Ashley Anna Sunny, 5 Sruthi Susan Sam. Department of Electronics & Communication Engineering,Mar Baselios College of Engineering and Technology,Mar IvaniosVidya Nagar, Bethany Hills , Nalanchira Thiruvananthapuram -15, Kerala, India ABSTRACT The ECG signals captured from the body of the patient using three electrode model is processed and conditioned by the analog front end device is finally sent to the data acquisition unit. The data acquisition unit used is the user pc/ laptop with MATLAB. Using very specific image processing techniques the critical intelligence from the captured image is extracted. From this processed image any sort of abnormal conditions is determined which is informed to the corresponding doctor via text message. Simultaneously the processed image is sent to the doctor mail by using specific TCP/IP protocol. KEYWORDS DFT, FFT, IFFT, LPF, Arduino I. INTRODUCTION In Telemedicine communication through audio and video is done to convey or exchange the details of a patient with a physician. Using this process the details of a patient can also be discussed and analysed. In health information technology Telemedicine plays a major role. Telemedicine is basically the combination of medicine & information technology. This involves the transmission of medical information electronically. Hence this can be used for conveying the condition and status of patient to a doctor if the doctor is not available near the patient. Different methods can be applied for this purpose For example: store-and-forward technology, secure messaging; e-mailing, By monitoring the data received, the doctor is able to understand the patient's condition, to diagnose the disease and to take remedial measures. Videoconference is an effective measure in this case. 2. TELE MONITORING Tele monitoring is the monitoring patients who are not at the same location as the doctor. For example consider a patient with monitoring devices at home. He can easily transmit the results of to the doctor through telephone. This assists the patient to perform the initial and basic stage of health care by himself. Also this avoids the un necessary travel by the patient. Tele medicine is a fast growing field. A new type of Tele monitoring known as primary remote diagnostic disease has been introduced in a number of developing countries. In this technique devices are used by the doctor for the examination, diagnosis and treatment remotely. This type of treatment
  • 2. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 10 is mainly used for monitoring the chronic diseases which have been diagnosed already. But this new technology can also be applied for monitoring and diagnosing the common diseases such as blood pressure, blood glucose, heart rate, weight etc. Frequent monitoring of the patient's condition enables the physician to suggest the best and effective course of treatment to the patient. 3. COMPONENTS OF THE SYSTEM The system comprises of signal acquisition unit, processing unit and alerting system. The signal acquisition unit is the high precision analog front end IC named AD620A from Analog devices. It is a low cost, high accuracy instrumentation amplifier that requires only one external resistor to set gains from 1 to 1000. The low noise, low input bias current and low power of the AD620 make it well suited for medical applications such as ECG and non-invasive blood pressure monitors. For the simulation of the below mentioned image processing algorithm, we use ECG signal which is captured from the body in real time. The processing unit is coupled with a PIC micro controller which acts as the alerting system. Data processing unit comprises of user PC / Laptop loaded with MATLAB. 4. IMAGE PROCESSING The atrial or ventricular regularity or irregularity is a measure of the cardiac rhythm which in turn gives an idea about the regularity or irregularity of the heart beat. The consistency of patterns between the p waves accesses atrial regularity while the consistency of patterns between R waves accesses ventricular regularity. Typical ECG waveform is shown in Fig.No.1 Fig.No.1: Typical ECG waveform Initially eyeballing, the rhythm for regularity was used. Now two more methods are available, one is the use of callipers and the other is paper technique. In Callipers two needle points are hinged together , one placed at the peak of the P wave or R wave and the other placed at the peak of the subsequent P wave or R wave. The needle points are held steadily and the callipers are moved down the strip. The needle points of the calliper if fall at the peaks of the subsequent P waves shows atrial regularity. If the needle point falls on the peaks other subsequent R waves shows ventricular regularity. On the other hand if the needle point do not fall at the peaks of the P waves or R waves shows atrial and ventricular irregularities respectively.
  • 3. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 11 In paper technique a clean and straight edge of paper is lined up with the peak of the P waves or R waves. Three P wave peaks in a row are marked on the edge of the paper and the paper is then moved to three subsequent P wave peaks. If the initial marks match with the marks of the subsequent P waves that shows atrial regularity and if there is no matching between the marks it shows atrial irregularity. Similarly ventricular regularity or irregularity is determined by repeating the process with Rwaves. 5. IMPLEMENTATION ALGORITHM Fig.No.2 Block diagram of Algorithm Step1: Obtain ECG signal from the controller, which is in digital form. The digital values obtained in the controller is collected in MATLAB software in real time. Step 2: Apply smooth filtering process to remove higher frequencies. The most randomly occurring signals are eliminated by setting a threshold value. These high frequency signals do not contribute any intelligence. It may be due to loose contacts in the electrode or variations in impedance matching. Step 3: To extract vital information from the ecg image apply wavelet decomposition technique.It is done by using the function ‘wavedec’. Step 4: Set a threshold value for identifying the critical condition in heart beat rate using the relation (maximum value-mean value) / 2. Step 5: R peak detection: Done using the function ‘waverec’, inverse of ‘wavedec’, which performs a multilevel one dimensional wavelet reconstruction. Step6: If the adjacent peak distance is greater than a specific value, save the corresponding image to a particular location in the computer. Step7: Calculate heart beat rate.
  • 4. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 12 From the final detected peaks any sort of abnormality can be easily detected. In case of emergency the PIC controller is triggered and the status of the patient is sent to the doctor as text message using a GSM modem as shown in the block diagram given below. Fig No 3. Block diagram representation of emergency alerting system 6. SIMULATION RESULTS The setup is as shown in the Fig No.4 Fig No 4. The system
  • 5. Health Informatics-A Fig No.6 7. EMERGENCY ALERTING The extracted vital intelligence in case of emergency is uploaded to the server. The image which is now saved in the server is automatically sent to the mail An International Journal (HIIJ) Vol.3, No.3,August 2014 Fig No 5 Final detected peaks Fig No.6.Screen shot of message on doctor’s handset LERTING SYSTEM The extracted vital intelligence in case of emergency is uploaded to the server. The image which is now saved in the server is automatically sent to the mail address of the doctors. In case of 13 The extracted vital intelligence in case of emergency is uploaded to the server. The image which the doctors. In case of
  • 6. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 14 emergency the trigger is given to PIC controller which will send text message to the doctor using GSM modem. From the server the critical ECG image is sent to doctor’s email address. For the website creation Microsoft Visual Studio 2010 is the IDE been used .The programming language used here is C#. Fig No.7.Login page of website Fig.No.8.ECG results of various patients.
  • 7. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 15 Fig No.9.List of doctors Fig.No.10.ECG image of patient displayed
  • 8. Health Informatics-An International Journal (HIIJ) Vol.3, No.3,August 2014 16 8. CONCLUSION This system is an initiative of automation in critical health care management. It provides continuous monitoring of patient and allows automatic data transfer. The system facilitates equitable access to the specialists for all patients regardless of their location. It provides opportunities for patients and relatives to contact their specialist. The system can completely automate the medical emergency conditions happening in an ICU. ACKNOWLEDMENT The authors would like to thank their colleagues at Mar Baselios College of Engineering and Technology for valuable discussions and feedback, also the reviewers for their constructive comments. REFERENCES [1]Lai Khin Wee, Yeo KeeJiar, EkoSupriyanto “Electrocardiogram Data Capturing System and Computerized Digitization using Image Processing Techniques” International Journal of Biology and Biomedical Engineering Issue 3, Volume 3, 2009 . [2]LjupˇcoHadˇzievski, BoˇskoBojovic´, VladanVukˇcevic´, PetarBeliˇcev, SiniˇsaPavlovic´, ZoranaVasiljevic´-Pokrajˇcic´, and MiodragOstojic´’A Novel Mobile Transtelephonic System With Synthesized 12-Lead ECG’ IEEE Transaction on Information Technology in Biomedicine, Volume 8, 2004 . [3]Prof. Dr. Burkhard Stiller ’Mobile Healthcare on Android Devices‟ Communication Systems Group, Diploma Thesis, Dept. of Informatics, November 2010 . [4]Karen Panetta, Yicong Zhou,SosAgaian,HongweiJia”Non linearunsharp masking for mammogram enhancement” , IEEE Transaction on Information Technology in Biomedicine Volume. 15, November 2011. [5]Al-Naima, F. M., A. H. Ali, and S. S. Mahdi. "Data acquisition for myocardial infarction classification based on wavelets and Neural Networks." Systems, Signals and Devices, 2008. IEEE SSD 2008.5th International Multi-Conference on.IEEE, 2008. [6]Chagas, A. V., E. A. B. Da Silva, and J. Nadal. "ECG data compression using wavelets." Computers in Cardiology 2000.IEEE, 2000.