i-MED

IndTech 2014 for Schools CONFIDENTIAL Page 1 of 12
09- 11 April 2014, Athens, Greece
“Industrial Technologies for Schools”
initiative
School Name: ZANNEIO MODEL EXPERIMENTAL LYCEUM
Title:
i-MED: A smart medical bracelet that will revolutionize
medical treatment
Contact Persons’ Details
Name:
Surname:
Email:
Phone:
Yannis
Grapsas
igrapsas@sch.gr
Date 17-03-2014
Industrial Technologies 2014 Conference, 09-11 April 2014, Athens, Greece

Industrial Technologies 2014 Conference, 09-11 April 2014, Athens, Greece
PARTICIPANTS
Students (name & surname)
Alexiou Panos
Antoniadis Apostolos
Asimakopoulou Georgia
Bouzali Drini
Droutsas Christos
Gerani Eirini
Ioannidis George
Megalogianni Melina
Nikolaidou Georgia
Oikonomopoulou Maria - Eleni
Papadopoulos Kostas
Spyrou Alexandros
Tsantilas Spyros
Tsavalos Sokratis
Vamnies Yannis
Vasilakou Sofia
Vidalis Kostas
Voglis Theologos
Vousvounis Spyros
Xanthidis George
Zaharopoulos Christos
Supervisors / Teachers (name & surname)
Pantelis Bouboulis
Martha Georgiou
Eva Tegkeri
Sotirios Tsantilas
Dimitrios Vamnies

Content
PARTICIPANTS .................................................................................................................................................. 2
ABSTRACT .......................................................................................................................................................... 4
1. INTRODUCTION....................................................................................................................................... 5
2. NEW PRODUCT / SERVICE DESCRIPTION....................................................................................... 6
3. CONCLUSIONS ....................................................................................................................................... 11
4. REFERENCES.......................................................................................................................................... 12
Industrial Technologies 2014 Conference

ABSTRACT
One of the major challenges of modern health care is the implementation of a pre-screening
process at the Emergency Department (E.D.) of Hospitals. Usually, these rooms are filled
with non-urgent cases, that could be redirected to a private physician or a health clinic saving
time and money. Although pre-screening methods have already been adopted in many
western Hospitals with great success, they are still time consuming as they rely on traditional
(low tech) techniques. Undeniably, these methods will benefit, if cutting edge technology is
to be adopted. In this report, we propose a high-tech medical bracelet, called i-MED, that will
revolutionize medical service both for emergency cases and regular patients. The device (that
will be attached to each patient's wrist) will be equipped with multiple sensors that can
monitor patients life signs (heart rate, pressure, temperature, O2 and glucose levels in the
blood, e.t.c.) using non-invasive techniques. In addition, the device will be able to take small
amounts of patients blood to perform further tests (Hb, white cells count, electrolytes,
troponin levels, toxins, cancer biomarkers, e.t.c.). i-MED will be able to interact with the
Hospital's Computer System and use the patient's history and the aforementioned
measurements to make a quick assessment of the severity of each case. When a patient's life
is on immediate danger, i-MED will turn red and alert the medical personnel. The proposed
device can also be used on regular patients who are admitted to the Hospital (e.g., for a
scheduled surgery operation). It can also be used on patients with severe life-threatening
conditions that need continuous off-site medical observation.

1. INTRODUCTION
Undoubtedly, Medical Science plays a fundamental role to the improvement of the
quality of life. Every technological advance is applied to it, in order to cure diseases, enhance
the precision of surgical operations and reduce patients' suffering. However, the current harsh
economic environment dictates that the expenses for health care need to be reduced.
Moreover, getting care in a crowded Emergency Department (E.D.) is quite difficult,
especially for people, whose lives depend on the immediate reaction of doctors. A suitable
solution to these issues would be to scan the patients in the emergency room, value the
severity of each case and decide which are non-urgent. In this way, people with actual need
will stay at the Emergency, while others will be redirected to a less expensive hospital-
appointed primary care provider or a health clinic. As any treatment in a Hospital E.D. costs
at least twice as much as that of a similar treatment in a primary care physician's office
(sometimes the cost increases even further to 300% or 400% [1, 2]), medical expenses will be
reduced, while serious cases will get more attention.
During the last decades, there have been some attempts to control the attendance at
the E. D. For example, Mercy Fort Smith Hospital has medical personnel making an initial
evaluation of each situation [1, 2]. The specialized personnel examine the patients and divide
them into categories based on the severity of each case. Although it is a notable initiative, it is
still time-consuming and has increased possibilities to mistakenly evaluate a patient’s health.
Although some symptoms may seem innocent they can be a warning of some severe sickness.
In most hospitals, people are patiently waiting for their turn to be examined, based on the
time of their arrival. So, people with insignificant maladies may take priority over those in
direct danger.
To address these issues, we propose the use of a multitasking bracelet, called i-MED.
Besides the replacement of the typical medical bracelet, our approach considers a complete
medical service that will help medical personnel in multiple ways. i-MED will not only be
able to take pressure and temperature measurements, but it will also monitor heart and
analyze blood samples, in order to make generic or specialized blood tests to detect infectious
diseases or anomalies that indicate the existence of greater threats. The results of all these
measurements will be immediately sent to a server that will judge the severity of each case
and will order the bracelet to light red in high jeopardy, yellow in medium and green in non-
urgent cases. i-MED can also track the location where each patient is at any time, an
application really useful for patients suffering from dementia, Alzheimer or memory loss. It
can even prevent young unsupervised children from entering rooms without access saving
medical personnel's time and effort.
The rest of this report is organized as follows. Section 2.1 is devoted to analyze the
pre-screening rationale at E.D. employed by major western Hospitals. A complete description
of the i-MED device can be found in Section 2.2, while Section 2.3 analyzes the main
functions of the i-MED system.

2. NEW PRODUCT / SERVICE DESCRIPTION
2.1 E.D. pre-screening
Thankfully, our civilization has reached a point, where many serious conditions can
be efficiently dealt with. However, in most western hospitals the care of urgent cases is less
than efficient. Many times, the E.D. are crowded with worried patients without severe
symptoms, spending valuable medical time, which should have been redirected to more
critical cases [2]. As a result, the rate of treatments is slowed down keeping many patients in
immediate danger. Moreover, the costs of all these visits at the E.D. are excessive. If a way to
minimize E.D. visits and costs was found, countries would save money from their health care
budget, that could be invested in scientific research and further improvement of the quality
service.
It is widely accepted that Medical Science is a fundamental factor for the
improvement of life. However, health care is among the first that suffers budget cut-offs in
time of economic recession. Although diminishing health care costs has instant effects in a
country’s budget, over time the governments need to help those whose financial situation is
restrictive to receive the proper health care. Thus, the money that has been saved will be
subsequently lost in social benefits. Clearly, this is not a viable solution. In this report we
propose a medical service that addresses these problems more efficiently, without
undermining public health care benefits. Our focus is the decongestion of the E.D. from
patients without immediate danger, a policy which has already attracted attention in the U.S.
as a means to reduce health care costs [1,2]. Many hospitals assign specialized medical
personnel to pre-screen patients, in order to control the attendance at the E.D. It has been
found that this policy is quite effective in saving money. As noted by an emergency physician
at a major US health care center, i.e., the New York's Presbyterian Hospital, in the E.D., a
sore throat could cost $600, while treatment in a primary care physician's office would be
only $120 [1,2]. That's a significant cost reduction. Besides, primary care physicians and
health clinics offer more flexible hours and a wide range of less expensive healthcare
services. More and more US hospitals adopt pre-screening techniques as a means to reduce
their operating expenses [2]. For example, Milwaukee-based Aurora Sinai Medical Center,
reduced its annual E.D. visits by 23 percent by matching non-urgent patients with other
providers, while Florida's Halifax Health pre-screens patients aged 18 to 64 prior entering the
E.D. and redirects the non-urgent cases (as determined by a physician or a physician's
assistant) to an on-site health clinic.
However, these means are still at their infancy. It takes a lot of time for the medical
personnel to pre-screen every case at the E.R. and be sure that their judgment is accurate. On
the other hand, an intelligent medical bracelet that could evaluate fast each patients case,
would be ideal. Such a device would analyze each case separately by monitoring the patients'
life signs (heart rate, temperature, blood pressure, e.t.c.) and possibly taking and analyzing
blood samples to determine infections or other conditions. The device would then transmit
the acquired information to the Hospital's Server, which, in turn, will compare the results to
the patient's medical history and asses the severity of the case. The medical personnel will use
this information to decide on the fly which case takes priority, while the non-urgent cases will
be redirected elsewhere. Besides, such a device would revolutionize health care as we know
it, since it could also be used by Hospitals to monitor patients with life-threatening

conditions, who are currently off site either for personal reasons (e.g., visiting relatives,
talking a walk), or because they do not need permanent Hospital attention.
Figure 1. The i-MED bracelet.
2.2 i-MED's description
i-MED will be a wrist bracelet (Figure 1) incorporating the flexible screen
technology, and will be given to each patient along his entrance to the hospital. This high
technology bracelet will be in contact with each patient’s skin through internal sensors
incorporated at its back side (Figure 2). These sensors will be able to periodically analyze the
patient's life signs (heart rate, temperature, pressure, e.t.c.) using non-invasive techniques.
The sensors will also be able to get some blood-related measurements that do not require an
actual blood sample (like SatO2, CO, glucose, radiation levels, e.t.c.). Note, that there is
ongoing research to identify non-invasive methods that can take accurate blood
measurements and the interest of the medical community for such methods is increasing [3,4,
5,7,9].

Besides the non-invasive measurements that will be periodically taken through the
sensor array, i-MED will also include a needle-like component at the back side of the bracelet
that will be able to receive blood samples in order to analyze them, using an inbound chip
mechanism. These tests will be carried out only if the medical personnel orders them and they
will cover the basic blood measurements. It is of high importance for doctors at the E.D. to
have a quick and direct outlook of the function of the circulatory system, thus the bracelet
will be able to perform the basic blood examinations that involve the level of leucocytes,
platelets, cholesterol, allergies, e.t.c., or identify the presence of infections, viruses, chemical
agents, e.t.c.
Figure 2. Front and Back side of the (unfolded) i-MED bracelet.
The bracelet's front side will be a flexible screen, which will be separated into three
different areas. The first one will depict temperature and pressure measurements periodically
together with the non-invasive blood tests, while the second one will depict heart rate
measurements. Finally, the third area will show everything else including, possible blood
tests, medical history, diagnosis, e.t.c. The bracelet will be made of graphene's compounds
and it will change colour depending on the patient’s health and how critical his condition is.
In order to send and receive data (i.e., patient's history, condition at the E.D., emergency
calls, e.t.c.), i-MED will also be equipped with a wireless port. Hence, i-MED will be able to
communicate with the Hospital's computer server to complete its task. Moreover, i-MED will
include a GPS module that will make possible the positioning of the patients inside the
Hospital's perimeter. This is of paramount importance for patients suffering from dementia,

or other conditions that compromise brain functions. i-MED will be composed of
nanomaterials, which will give it both flexibility and endurance, as well as make it compact
and lightweight. While the patient waits for his turn to be examined by a doctor, the bracelet
will transmit the data to the main server through the wireless interface and the patient will be
able to monitor the results. Finally, the device will contain a rechargeable battery, which will
be recharged wirelessly.
2.3 i-MED's functionality
i-MED is a multitasking gadget that is able to accommodate a wide variety of
Hospital's functions. In this section we divide its functionality into three different modes: a)
ED Mode, b) Regular Mode and c) Off-site Mode.
The ED Mode will help medical personnel perform pre-screening of patients in the
E.D. An i-MED bracelet will be given to each patient arriving at the E.D. The bracelet will
immediately start taking the non-invasive measurements and if doctors decide that the patient
needs further tests (or if its software decides that this is necessary), they can remotely
command the bracelet to do any additional examinations (e.g. blood tests through the needle),
provided that they supply it with the needed chip and chemical agent. Due to its
programmable nature, i-MED’s system will be designed to be configurable, so that new tests
or even generic functions can be integrated by specialists without the need of a complete
restructuring of its internal mechanism. We should point out that devices that can run cheap
and efficient measurements using only a small drop of blood are already in existence (e.g. the
V-Chip (see figure 3) [6,8,10]). These devices only require the right agents to react with the
blood ingredients one wants to check. Hence, in a case of an outbreak, i-MED will indicate
the existence of viruses in the blood and it will immediately alert the medical personnel to put
the host in quarantine. i-MED will use all the acquired information together with the patient's
history to decide the priority of the particular case and dynamically allocate the patient's place
in the E.D. queue. Depending on the severity of the case, the i-MED will light using a
specific colour.
 Green, if patient’s health is well or relatively well and his symptoms are negligible
 Yellow, if the patient needs to be examined but immediate medical attention is not
necessary
 Red, if the patient has to be examined right away because of a potential critical
condition.
This provides an immediate priority system for medical personnel which works in parallel
with the server communication system. For example, if the symptoms depict severe disorders
regarding homeostasis, the bracelet will light red make a beeping sound to alert the medical
personnel that the patient needs to be in the priority queue. When a patient’s life signs are in
the normal rates, the bracelet will light green and he/she will be able to set an appointment
with a private physician or a public health clinic. i-MED will suggest the specialty for the
patient’s needs, based on a questionnaire he/she will answer about his condition. This will be
filled in while i-MED runs the various medical tests.
The Regular Mode will be applied to patients during their scheduled hospitalization
(e.g., for surgery, check up, or other reasons). In this case, the bracelet will provide accurate
and continuous monitoring of the patient's health and the effectiveness of the treatment they
follow. For example, i-MED can run blood tests that will display the effects of the medicine
to the monitored patient. The results of those tests will be combined in order to build a map
that indicates how each drug interacts with each organ and whether they provoke any side
effects. Blood pressure, pulse and other life signs will be continuously monitored and the

combination of the results will be evaluated. Every disorder will be considered by all possible
symptom checks and the bracelet will make a primary diagnosis. In the case of an emergency
(e.g., if an abnormality in patient's life signs is detected) the i-MED will alert the medical
personnel. Furthermore, i-MED will be able to automatically position each patient inside the
Hospital's perimeter. This is quite useful for people suffering from dementia or other related
conditions. It is also useful for young children and patients who need special care.
The Off-site Mode: A lot of people suffer from severe medical conditions, that
require regular treatments, but not a continuous hospitalization. In fact, the latter might
negatively influence a patient's psychology leading to undesirable outcomes. In cases where a
patient faces a severe problem and has to be monitored continuously, there will be a
specialized i-MED for certain major conditions, which will be provided to each patient to
enable doctors for discrete constant ‘surveillance’ of the patient’s condition. The i-MED will
continuously monitor patient's life signs and location and in case of emergency a special unit
will be directed to the patient's position to provide assistance.
Apart from its medical use, i-MED will be a practical tool for the administration
department. Information gained from the bracelet will be sent to a server that will have the
medical record of each patient. This data can be used in statistic research about the
effectiveness of a treatment, or the number of patients suffering from a certain disease.
Moreover, the server can combine the information from multiple patients about the side
effects of the treatment. These results can be utilized by the pharmaceutical companies in
order to improve their products. The server will keep record of the hospitalization costs for
each patient as well and the cost and effectiveness of each treatment.
Figure 3. The V-Chip

3. CONCLUSIONS
We presented a medical device, which has the potential to greatly improve the quality
of medical service, and thus offering a lot to modern society, addressing a part of today’s
worldwide issue of Health Care. It is an innovation that will help to solve the problem of
congestion in the Emergency Department by improving the pre-screening techniques. Thus,
hospitals will be able to channel their recourses to their primary goal: saving lives. i-MED
will, also, reduce the unnecessary visits at the E.D. That can be interpreted as a significant
amount of money saved from the annual budget and can be invested in further scientific
research. This bracelet will be able to run general blood examinations on demand and
monitor heart rate, blood pressure, temperature and other life signs periodically. Every
bracelet will be connected through wi-fi to a computer server and the results will be instantly
transferred to the medical record of each patient. It will evaluate the severity of each case and
decide which patient should be treated firstly employing a simple colour coding. The system
will give priority to life threatening conditions, while in trivial cases it will redirect the
patients to a health clinic or a private physician. This will result to a significant gain in
medical time that will be redirected to more severe cases. Moreover, it will have further use
in monitoring patients suffering from chronic diseases, who remain in the hospital area in fear
of complications without receiving any additional treatment than that they could receive at
their home.

4. REFERENCES
[1] Alicia Caramenico, Trend: Hospitals pre-screen, divert ER patients to cut visits,
http://www.fiercehealthcare.com/story/trend-hospitals-pre-screen-divert-er-patients-cut-
visits/2012-03-06
[2] Rusty Garrett, ER Screening Policies In Place At Local Hospitals, Times Record (online
edition), URL swtimes.com/sections/business/er-screening-policies-place-local-
hospitals.html
[3] Lior Golan, Daniella Yeheskely-Hayon, Limor Minai, Eldad J Dann, and Dvir Yelin,,
Noninvasive imaging of flowing blood cells using label-free spectrally encoded flow
cytometry, Biomed. Opt. Express, (2012)
[4] Robert Hahn, Y Li and Johann Zdolsek, Non-invasive monitoring of blood haemoglobin
for analysis of fluid volume kinetics, 2010, Acta Anaesthesiologica Scandinavica, (54), 10,
1233- 1240.
[5] Mark Heimberg, Raman technique enables noninvasive blood test, Laser Focus World,
URL http://www.laserfocusworld.com/articles/print/volume-39/issue-3/world-news/raman-
technique-enables-noninvasive-blood-test.html
[6] Elizabeth Holmes, Theranos, URL www.theranos.com/
[7] J. U. Kang, Non-Invasive Fiber-Optic Glucose Sensor Based on Stimulated Raman
Scattering, The 20th Annual Meeting of the IEEE Lasers and Electro-Optics Society, 2007.
LEOS 2007.
[8] Tuan C. Nguyen, How To Run 30 Health Tests On a Single Drop of Blood, Smisthonian
magazine (online) URL www.smithsonianmag.com/innovation/how-to-run-30-health-tests-
on-a-single-drop-of-blood-180949983/?no-ist
[9] Wei-Chuan Shih, Quantitative biological Raman spectroscopy for non-invasive blood
analysis, Ph.D. Thesis, MIT, 2007
[10] Yujun Song, Yuanqing Zhang, Paul E. Bernard, James M. Reuben, Naoto T. Ueno,Ralph
B. Arlinghaus, Youli Zu, Lidong Qin, Multiplexed volumetric bar-chart chip for point-of-
care diagnostics, Nature Communications 3, article ID 1283, 2012.

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