Pulse Oximeter Based Mobile Biotelemetry Application

Annual Review of Cybertherapy and Telemedicine 2012 B.K. Wiederhold and G. Riva (Eds.) IOS Press, 2012 © 2012 Interactive Media Institute and IOS Press. All rights reserved. doi:10.3233/978-1-61499-121-2-197

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Pulse Oximeter Based Mobile Biotelemetry Application Ali Hakan IŞIKa,1 ,İnan GÜLER b a,b Gazi University, Faculty of Technology, Department of Electronics and Computer Technology, Ankara, Abstract Quality and features of tele-homecare are improved by information and communication technologies. In this context, a pulse oximeter-based mobile biotelemetry application is developed. With this application, patients can measure own oxygen saturation and heart rate through Bluetooth pulse oximeter at home. Bluetooth virtual serial port protocol is used to send the test results from pulse oximeter to the smart phone. These data are converted into XML type and transmitted to remote web server database via smart phone. In transmission of data, GPRS, WLAN or 3G can be used. The rule based algorithm is used in the decision making process. By default, the threshold value of oxygen saturation is 80; the heart rate threshold values are 40 and 150 respectively. If the patient’s heart rate is out of the threshold values or the oxygen saturation is below the threshold value, an emergency SMS is sent to the doctor. By this way, the directing of an ambulance to the patient can be performed by doctor. The doctor for different patients can change these threshold values. The conversion of the result of the evaluated data to SMS XML template is done on the web server. Another important component of the application is web-based monitoring of pulse oximeter data. The web page provides access to of all patient data, so the doctors can follow their patients and send e-mail related to the evaluation of the disease. In addition, patients can follow own data on this page. Eight patients have become part of the procedure. It is believed that developed application will facilitate pulse oximeterbased measurement from anywhere and at anytime. Keywords. COPD, Wireless, Smart Phone, XML

Introduction Home-remote monitoring is a beneficial way for the management of diseases. In this case, the biomedical data are collected from distance and transferred via the Internet to a central hosting service. The retrieved data are evaluated with decision support algorithms. There are so many studies related to the decision support applications in biotelemetry. In an online rule based study, all the information related to the person’s basic life functions such as ECG, blood pressure and geographical location (GPS) are transmitted by means of GPRS to the control centre [1]. In Konstantikaki and colleague’s' work, an open spirometry programme and a case-finding programme are statistically compared [2]. In Janckulik and colleague’s' work, ECG data is sent to the PDA by means of Bluetooth technology. Then, these data are transferred to the remote server. For the analysis of received ECG data, a self-organizing neural network is used [3]. 1

Ali Hakan IŞIK, Gazi University, Faculty of Technology, Department of Electronics and Computer Technology, Ankara; E-mail: [email protected].

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˙ Güler / Pulse Oximeter Based Mobile Biotelemetry Application A.H. I¸sik and I.

Many studies have been conducted in this field. In Hebert and colleagues’ work, when patients with severe respiratory illness requiring long-term oxygen therapy are remotely-monitored, hospital admissions are decreased by 50 percent, acute home exacerbations are decreased 55 percent, and the hospitalization costs are reduced by 17 percent, even after the costs of monitoring are included [4]. In Toledo and colleague’s work, a feasible and reliable tele-homecare system for chronic obstructive pulmonary patients is presented. In this system, hospital admissions are decreased by 51 percent [5]. The technical details and the testing of pulse oximeter-based care application are presented in this paper. The application consists of finger-type pulse oximeter, a mobile smart phone, a XML web services, a web server database, and a web page. First of all, the pulse oximeter data are acquired by Bluetooth virtual serial port protocol. Then, the data are processed in real time on mobile smart phone with rule-based algorithm. If the evaluation has emergency condition, generated result is sent to the doctor by means of an SMS to take a precaution. The doctor can direct an ambulance or an emergency person to the related patient. In addition, generated and obtained data can be visualized on the web page. This paper is organized in three sections. The first section aims to summarize healthcare monitoring and to emphasize the importance of wireless biotelemetry. The features and technical details of the pulse-oximeter based care application are presented in the second section. Finally, in the third section, the results are evaluated and the conclusion is presented.

1. Wireless Biotelemetry in Healthcare Monitoring Wireless biotelemetry of biomedical signals is desirable in many research and clinical applications. These include but are not limited to biotelemetry and the recording of neural activity in laboratory animals and implantable devices for sensory [6]. In addition, the monitoring of biomedical data will have a critical value in many scenarios: for use in patient-clinician discussions at a later time; for connection to an alert system for both patient and provider who has warning of deteriorating clinical status; and/or for immediate linkage to databases, decision support systems, and algorithms for mobile patient self-management based on plans and parameters previously determined by caregivers [7]. It is expected that mobile health application will commonly be used in the next few years [8].

2. Material and Methods As shown in Figure 1, finger type pulse oximeter (produced by NONIN) is used in the application. The weight of the device is 63. gr and can be used without interrupting the daily work.


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Figure 1 Bluetooth enabled pulse oximeter [9]

In developed application, the patient can measure his/her own heart rate and oxygen saturation with this device. Then, the data is automatically sent to a smart phone by means of a Bluetooth serial port protocol. In transmission of data from the smart phone to the remote web server, GPRS, WLAN or 3G can be used. In this transmission, XML SOAP protocol is utilized. Patient can check own data with smart phone or on pulse oximeter screen. The retrieved data are evaluated and the rule-based decision-making is performed. In rule-based decision-making, the oxygen saturation threshold value is 80; the heart rate threshold values are 40 and 150 respectively. If measured oxygen saturation is below the threshold value or heart rate is out of the threshold values, measurement is accepted as an emergency condition. Then, SMS is sent to the doctor. The doctor may contact with hospital or ambulance for treatment purposes. In addition, the doctor or the patient can access generated and measured data with PHP-based web page. The web page provides statistical data about the development of the disease. Designed web page is shown in Figure 2.

Figure 2. Web page of the application

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Shown in Figure 3, the designed application under study consists of three main units. These are patient, remote, and expert support units. The pulse oximeter test module, which communicates with smart phone, provides the reception of test results from pulse oximeter by means of the Bluetooth virtual serial port protocol. The decision support module is the most important module of application, which works on mobile phone. Nokia 5800 is used as a smart phone. This smart phone is cheap and also has adequate features such as 3G, WLAN, GPRS and Bluetooth facilities. Real time evaluation of data and the generation of the result is achieved using rule-based algorithm. The communication module provides connection with the remote unit that includes XML Web service. The XML Web service is used to store measured and generated data in the remote server database and also vice versa. GPRS, WLAN, or 3G networks can be used for transferring the data from smart phone to the remote server database.

Figure 3. The technical structure of application

There is a MySQL in server database module that is located in remote unit. In this database, the test data of patients, and the generated results are stored. SMS can be sent through SMS module. In addition, BP-ANN results and recommended actions are converted automatically into SMS XML template in SMS module. Then, SMS is sent to the doctor for emergency purposes. The web portal module, which is located in the expert support unit, provides secure accession through web page. It is used for patients’ self control; revision and the tracking of patients’ measured and generated test results. The doctor and the patient can send an e-mail to each other through web page for treatment purposes [10].

3. Results and Conclusion The application is developed with Java 2 Micro Edition environment and tested with eight patients in home environment. The ages of patients are between 36 and 60. Selected patients are visited in their homes. During these visits, detailed information about pulse oximeter and a smart phone are given. They can easily use finger type pulse oximeter. In application trial, some elderly patients can’t properly use the smart phone. However, patients who already have smart phone can easily use the application. For instance, a 42-years old patient who already has smart phone can easily use the application. In addition, he checks his pulse oximeter data with web pages.


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The primary purposes of the study are to deliver the cost effective, real-time, ease of use, and quality healthcare for patients at home comfort over wireless network. It is expected that the application will provide reduction in the number of doctors visit, increase in the quality of life of patient, and decrease in the cost of treatment. In addition, the application will facilitate pulse oximeter-based measurement from anywhere and at anytime.

Acknowledgments This work was supported in part by the Gazi University scientific research project (BAP-07/2012-02).

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