Remote Patient Monitoring

 

What is Patient Monitoring?

    In medicine, monitoring is the observation/detection of a disease, condition or one or several medical parameters over time.

Remote patient monitoring (RPM) uses digital technologies to collect medical  data of the patient for assessment.

What is the need of Remote Patient monitoring?

    In such rough times of COVID 19 this technology can help many patients and doctor, remote patient monitoring has become a household term among healthcare providers and their patients. Even in the recovery phase patient can check there vital signs from home only. Data is sent via Bluetooth/Internet to healthcare providers who then can determine the recovery progress and if further intervention is needed.

 

What are the benefits of remote patient monitoring?

 

Saves Money

Remote Patient Monitor can save money of the patient as the doctor can give do checkup from one place only. A patient can consult a doctor online rather than physical check up (except emergency).

 

Makes healthcare accessible

    Remote monitoring enables no contact patient consultation so that people having COVID 19 can consult the doctor without risk of exposure. The technology ensures timely communication, quick counselling, and time to make preventive measured if deemed necessary.

 

Makes healthcare efficient

    Staff burnout/unavailability is a critical problem for most hospitals. Also we have seen confusions in the hospital in this COVID 19 period in many hospital due to rush. Artificial Intelligence-powered remote patient monitoring technologies automate process the process of regular checkup of patient.

Some Remote Patient Monitoring System 

1) Respiratory or Heart Disease RPM

        Respiratory disease is a medical term which affects the lungs and other parts of heart. Heart rate is the speed of heartbeat measured by the number of contraction of the heart per minute (bpm). Heart rate is most important parameter that is to be measured and observed regularly

Components

·       CMOS camera, OpenCV

Working

CMOS Doppler radar sensor which is used to measure motion of heart and respiration. A CMOS Doppler radar sensor has been developed to measure heart rate and respiratory rate. The quadrature direct conversion radar transceiver has been fully integrated in 0.25-mum CMOS, the baseband analog signal conditioning has been developed on a PCB(Printed Circuit Board)

The method is divided into two different section.

1)                 Finding the Respiratory rate

2)                 Finding the Heart rate

The author[1] suggested a method for non-contact measurement of multiple vital signs, i.e. facial skin temperature and respiratory and heart rates, with a CMOS camera based on RGB image processing. Respiratory rate is determined by measuring the frequent temperature changes of nasal region thermal images. And by capturing the changes in brightness of RGB facial images induced by fluctuations in skin, heart rate is calculated. A CMOS camera is used to evaluate the efficiency of heart rate and respiratory rate.

 

Using OpenCV in real time, the RGB images were acquired and analysed in Python. Just in Fig. 1 The technique for measuring respiratory and cardiac rates is shown. As a CMOS IR camera, the TVS-500EXLV is used to combine the sensor camera and IR camera, and also to provide thermal and RGB fusion mode. The ratio of thermal and RGB overlapping images is adjustable. Mixed-images of the thermal/RGB were obtained at 30 frames per sec with a 640 × 480 pixel solution; a camera will capture the image of a person using CMOS camera and each image is send to PC.

 

The first image of RGB-predominant images is used to measure the heart rates. The ROI (pixel solution was approximately 150 x180 pixels) is defined as the center of the face of the subject. All images were obtained by configuring only the green plane signals; the author measured the mean brightness value of each image as follows: The CMOS camera used the mean brightness value obtained to of each image as follows CMOS Camera used the obtained mean brightness value to create the waveform. The heart rates were calculated in the same analysis program with respiratory rates, except for the setting of the band-pass filter (0.83–2.0 Hz).

2) Fall Detection System

    A)Wearable Sensor Based 

        Falling or accident of the elderly people often lead to serious health issues as it has a serious affect on their physical fitness. Fracture is one of the most common injury in fall of an elderly and there is also a  possibility to get coma, brain trauma, and paralysis. At most fall situations, the fall process is the main source of injury due to high impact. But sometimes the late medical help may worsen the things. That means the faster the help comes, the less risk the elderly will face.

    

picture - 2

    B)Camera based fall detection

        A camera-based detection can be done using change in shape ,posture of the patient ,patients head motion in 3D and his/her inactivity , but to have simple solution, a 2D method can be used in which we have to detect/locate first the patient in the video and draw bounding box around the person. The feature that can be extracted from this is aspect ratio. This particular aspect ratio  can be calculated using ratio of the bounding box around the patient and the height .A small aspect ratio means the user is upright and a larger aspect ratio means the patient is lying down. Instead of bounding box we can also use ellipse which can provide more information than bonding box. A fall angle is the angle between the long axis of bonding ellipse and the horizontal direction. A small angle represents that the person has fallen. checking aspect ratio can be difficult if the light conditions are not good ,position of person ,occluding object , etc. 

3)    Continuous Glucose Monitoring

    CGMS or continuous glucose monitoring tracks blood glucose levels automatically throughout the day - night. You can see your glucose level anytime at a glance.

We can review how our  glucose level changes over a few hours or days to see the stats.

Seeing glucose levels in real time can help you make more informed decisions throughout the day about how to balance your food, physical activity, and medicines.

How does a continuous glucose monitor (CGM) work?: 

Picture -3

What are the benefits of a CGM?

After comparing  with a standard blood glucose meter, using a CGM system can help you

·        better manage your glucose levels every day

·        have fewer low /high blood glucose emergencies

·        need less finger sticks

References:

[1] https://www.ijareeie.com/upload/2017/june/127_Syrvey_IEEE.pdf

[2] https://www.hindawi.com/journals/ijta/2015/576364/

[3]https://www.researchgate.net/publication/320337474_Fall_detection_monitoring_systems_a_comprehensive_review

Picture  2 -  https://www.amrita.edu/center/awna/research/wearable-sensor-development

Picture3-https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring