Transcript Wireless Health Care World

Wireless Healthcare World
Marc Bage, Ph.D., ing.
International Institute of Telecommunications - Research
INET 2007
Toronto, ON
20 June 2007
Agenda
 Technologies
 Taxonomy
 Applications




Wireless Devices
Consulting
Diagnosis
Monitoring
 Systems
 Projects
 Care Process
 Benefits
 3 Points of View
 Challenges
 Conclusions
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Consultation, Diagnosis,
Monitor in Remote Areas
Diagnosis
100 EPR, Comm.
C Mb/s Process,
a
p 10
Mb/s
a
c
1
i Mb/s
t
y 100
kb/s
10
kb/s 1
cm
Microwave
& Satellite
Mesh
WiFi
Passive Active
IrDA
RFID RFID
Rev. B
WiMax
Rev.A/HSDPA
Intensive
1xEV-DO
Bluetooth
Monitoring,
EPR,
Wireless
ZigBee
Comm.
Devices,
3G
Diagnosis,
Continuous Monitoring Process
Process
ZigBee
2.5G
Range
10
cm
1
m
BAN
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10
m
100
m
LAN
1
km
Access
International Institute of Telecommunications
10
km
100
km
WAN
Taxonomy of Wireless Technologies
1
Gb/s
3
Wireless Monitoring Devices
Temperature
Weight
Expect
Increasing Integration
with Cell Phone
Using Bluetooth and
RFID !!
ECG
Oxygen
Glucometer
Heart
Rate
Blood
Pressure
Location
Stethoscope
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Consulting
 REACH (ON)
 Assertive Community Treatment (ACT)
 Medical Home Care Solution (Teleconference, Remote Vital
Sign Monitoring)
 Telesat, London Health Sciences Center Research + others
 3GDoctor (UK)
 Cellular Form Filling
 Screening of Patient Based on Health-Related Questions
 MyFoodPhone (Qc)
 3G Imaging of Meal
 Dietician Feedback + …
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Consulting
 Telerobotic
 Devine-Tidewater Urology (Virginia)
 St-Joseph Mercy Oakland Hospital (Pontiac, Michigan)

Physian Rounds
Patient Length of Stay
 Alzheimer's Disease
 Silverado Senior Living (Los Angeles)
 InTouch Health Inc. (California)
 Qualcomm (San Diego)

Rev.A
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Diagnosis
 Bravo Capsule
 Wireless pH-metry
 Medtronic (Minneapolis)
 Gastroenterology
 Gastric Acid Reflux Detection


RFID impedance monitoring system that uses electrical
impulses to detect oesophageal reflux
U of Texas Southwestern Medical Center doctors and UT
Arlington engineers
 Capsule Endoscopy
 PillCam = Two-Sided Camera + Light
 2600 Color Pictures; 14 Frames per Second
 Given Imaging (Israel)
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Wireless Monitoring Systems
 Télémédic (Qc)
 SpO2, Temperature, Heart Rate
 AMON: Advanced care and alert portable telemedical MONitor (Israel)
 Alive Technologies (Australia)
 SpO2 , ECG, GPS, accelerometer
 Sleep Apnea, Atrial Fibrillation
 Medtronic (Minneapolis)
 Implantable Defibrillator
 Measures Pressure and Fluid inside a Patient's Heart
 Sensor for Medicine and Science (Maryland)
 Glucose Sensor to be Implanted Under Skin of Forearm (in Development)
 Fluorescence-Based
 Oxygen Sensor
 Medical Intelligence (Qc, Fr)
 Alzheimer Disease: Alarm when Crossing a Programmable Virtual Fence
 Urgentys: GPS- and WiFi-Based Location + Voice and Alerts
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Monitoring Projects
 MobiHelath
 7 Sub-Pprojects : Home Monitoring, Trauma, Nurse Visits
 Risky pregnancies, Chronic Obstrusive Pulmonary Disease, Ventricular
Arrythmias
 U of Twente (NL), Germany, Spain, Sweden, Ericsson (Ge), Philips (NL)
 IIT-R
 3G-Based Proofs of Concept
 Biomonitoring (Contextual Analysis and Actions)
 Teletrauma (Ambulance to Hospital: Voice, EPR, ECG, Other Signs, Video,
Camera Remote Control, Image, Annotation)
 WIISARD





Monitoring in Disasters and Mass Casualties
Communications Between First Responders
Fault Tolerant
Wireless Biomonitors in Mesh Ad-Hoc Networks
UCSD
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Care Process
 Communications
 Voice + Text Messaging



2-way handsfree voice-controlled wearable badge
Kingston General Hospital and St-Thomas Elgin General Hospital
Vocera Communications
 Medication On Demand
 RFID Access to Drug Dispensing Box
 Avancen (Florida)
 Logistics
 Outpatient Registration


Shorter and Fair Queuing
Tongren Hospital, China
 SMS Patient Reminder (UK)

At some outpatient clinics, reduced’ DNA rate by 30% (with only 20%
uptake by patients)
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RFID in Care Process
 Asset Management
 Up-to-Date-Inventory and Optimized Restocking
 Gurneys, Wheelchairs, Pacemakers, Stents, Mobile Lab Equipment
 Supply Chain Systems and Smart Shelving
 People Management (Doctors, Nurses, Patients)
 Access Control and Security
 Patient Flow Management
 Outpatient Tracking

waiting time, EPR, billing
 RFID in Patient ID Wrist Bracelet



saved lives, improved workflow efficiency, reduced cost of care
correct medication and surgical procedures
Siemens (Germany)
Bhagwan Mahaveer Jain Heart Center in Bangalore, India
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RFID Implants
 Size of Rice Grain
 Implanted Under Skin of Upper Arm

Surgical or Syringe
 Secure Access

Amal Graafstra, Washington, DC
 Electronic Patient Record
 Medical Implants


Alzheimer, diabetes, chronic diseases
Mexico City
 Animal Control


Government initiative to control rabies
all Portuguese dogs must be RFID tagged by 2007. Similarly in Serbia


dog's history
owner's information
 Verichip




by Applied Digital Solutions
+ Digital Angel (Glucose monitor)
Patient Identification
FDA 2004
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PHOTO: Amal Graafstra
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Care Process (more)
 Closing the Gap Healthcare Group
 Telus + HealthPhone (NZ) + Microsoft
 Community Care Management Solution



Optimize direct patient care time
Increase patient safety through one-time recording of clinical notes at the Point
of Care
Improve patient outcomes by facilitating sharing of healthcare information across
the continuum of care
 Taiwan Mobile Healthcare Services
 M-Taiwan Initiative
 Chunghwa Telecom + Nortel (WiMax)
 Mobile Nurse

Outpatient Registration
 Treatment Assistant

Access to EPR
 Wireless Care Genie

Bluetooth monitoring of patients
 Health Care Guru

Virtual Information center
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Benefits of Wireless Healthcare
 Patient’s Quality of Life



Mobility (Tetherless / Cordless, Ambulatory, Vehicular)
Home Treatment vs Hospital Treatment
Reduced Waiting Time, Travel Time and Travel Costs
 Medical and Professional Point of View


Early Detection of Upcoming Health Problem
More Sophisticated Healthcare
 Increasing Bandwidth



Better Prognosis
ECG Door to Needle/Balloon :




Imaging, X-Ray ECG
1 min saved = +11 days for patient
Saving of 20 to 55 min = + ?? days for patient
TEN-HMS
Philips Medical System
University of Hull (UK)
Swiss Institute of Medical
Informatics
Home Monitoring Increases Survival Rate by 15% in Post-Hospitalization Care + 26%
Reduction in Hospital Days per Patient Compared to Nurse Telephone Support.
Access to the Most Up-to-Date and Complete EPR
 System Improvements




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Reduced Bed Blocking
Reduced Nosocomial Infections
Single Data Entry (Resulting in Reduced Errors)
Reduction in Duplication of Tests and Analysis ($$$)
Inventory Control
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Challenges of Wireless Healthcare (1)
 Technical Issues
 Radiation Level


Fœtal
FDA Testing of RFID Effects on Drugs
 Power Supply




Battery Life
Range
Bandwidth
Environmentally-Save
 Financial Model
 Role of Cellular Operators
 Payer: Patient, Government, Insurance
 Logistics Issues
 How to Work Differently
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Challenges (2): Patient Concerns
 Product and Service Features
adapted from G.Kang, BUPT, "Attitude tow ards Wireless Applications in Healthcare Industry in China"
Acceptability of Wireless Healthcare
 Accuracy and Radiation
 BUPT (Beijing University of
Post and Telecom)
Willingness
Ergonomy
Confidentiality
Concern
Price
Timeliness
Radiation
Accuracy
 Ethical Acceptability
0%
10%
20%
30%
40%
50%
60%
70%
 Human-Chipping Presentation, March, Prayer Vigil,

West Palm Beach, Florida, May 12, 2007
 CASPIAN: Customers Against Supermarket Privacy Invasion And
Numbering
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Conclusions
 Healthcare Providers Are Pushing Care Elements at
the Edge of the Healthcare Network. This is Where
Wireless Access Networking Can Help.
 Remote Care Also Needs Remote DiagnosTICs
 Demonstrated Technical Feasibility
 Economic Viability Yet To Be Proven
 Look at the Big Picture
 Challenge: How to Work Differently …
 World Wide Wireless Health is Progressing Fast.
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Thank You for your attention!
Dr Marc Bage, Researcher, 1.514.395.8018 / [email protected]
Vendors, products and services named in this presentation are for illustration purposes
only without any implied endorsement by IIT. Trademarks belong to their respective owners.
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