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Computing technology is in a state of continuous evolution. The state of the art computing paradigm called pervasive computing envisions a conglomeration of small smart devices like sensors, signal conditioners, wearable computers, mobile phones, notebook computers, hand helds, PDAs etc seamlessly integrated and scattered in the environment. The ultimate goal is to enable ANY TIME ANY WHERE computing and it has opened up exciting possibilities in the health care sector both in terms of diagnostic equipments and communication devices. In this paper we have proposed a new mechanism for the detection of silent heart attacks and providing an alert. The silent heart attack belongs to the high risk category. Since this does not trigger any visible indications unlike ordinary heart attacks it could be fatal. The only fool proof method of detecting this is through the deviation of the ECG (Electro cardiogram) pattern. The proposed scheme envisions a wearable diagnostic unit which will continuously pick up and monitor the ECG checking for abnormality. This is done based on a template matching procedure. The detection generates a trigger signal which is picked up by the patient's mobile phone and it causes a predefined message to be sent to a predefined number such as the doctor's mobile phone automatically without alerting the patient and causing panic. This communication process can be suitably enhanced like alerting the nearest or any chosen hospital by an automated call.
Keywords: pervasive computing, Heart attacks, mobile
The various computing technologies have been evolving continuously penetrating far and wide and increasingly influencing almost every aspect of our day-to-day life. The rapid advancing technology has blessed us with a host of versatile devices to make our life easier. The invention of equipments like abacus, transistor, ENIAC, PC, mobile phone etc defined new and higher levels of sophistication, use, and comfort for the human life.
The revolution unleshed by the massive penetration of cellular mobile phones has made it a community device like the radio. This was made possible by the tremendous growth in the new computation paradigm called PERVASIVE COMPUTING. This approach envisions a conglomeration of small smart devices like sensors, signal conditioners, wearable computers, mobile phones, notebook computers, hand-held's, PDA's etc seamlessly integrated and scattered in the environment. The ultimate goal is to enable ANY TIME ANY WHERE computing. And with the advent of Internet, the World Wide Web, and other networking technologies, instant communication and transmission of data were made possible, shrinking the world and bringing the people across the globe close together transcending geographic barriers.
PERVASIVE COMPUTING FOR HEALTH CARE
Pervasive health care focuses explicitly on the use of pervasive computing technology for developing tools and procedures that put the patient at the center of the health care process. From a technological stand point it includes remote monitoring, remote consultation, and assistive technologies.
A pictorial overview of the pervasive health care scenario is given below,
Have a glance on how much radiations are emitted by a normal mobile phone on a on brain while speaking.
This has opened up exciting possibilities in the health care sector both in terms of diagnostic equipments and communication devices. Now tele-medicine systems have sufficiently advanced so as to relay the medical data over large distances within a reasonable delay. Attempts are being made to develop intelligent wearable computers that can perform a primary diagnosis.
The authors choose to deal with heart attacks due to its lethal nature. Due to changes in life style and such other reasons the instances of heart attacks are on the rise.The risk of heart attack with respect to risk factors are represented below
III. ISSUES WITH CURRENT TECHNOLOGY
It is true that the currently available tele-medicine systems have sufficiently advanced when it comes to quick, efficient and reliable transmission of data like medical records like ECG, scan images and so on.
Brief glances at some important wearable cardiac devices are listed below.
Named after its inventor, Dr. Norman J. Holter is a portable device for continuously monitoring the electrical activity of the heart Holter monitor records electrical signals from the heart via a series of electrodes attached to the chest. The number and position of electrodes varies by model, but most Holter monitors employ from three to eight. These electrodes are connected to a small piece of equipment that is attached to the patient's belt, and is responsible for keeping a log of the heart's electrical activity throughout the recording period... This data is later downloaded to a PC and examined as an ECG pattern and analyzed using analysis software. The software gives a visual indication of any abnormality. A set of templates of ECG patterns have been derived and they serve as a reference.
Vitaphone Hertz handy:
This is a complete system for patients to measure an ECG signal and transmit the data to a central location called service center for analysis and further processing. A panic button is provided which on being pressed sends an alarm signal to the service center along with the patient's current GPS position
Welch allyn Micropaq:
It supports multi parameter monitoring like ECG display, heart rate, patient alarms, etc and also alarm messages from an Acuity Central Station. It extends patient care by providing patient alarms when it is out of range or not connected to the wireless network. The Micropaq can be integrated into wireless Ethernet Local Area Networks.
This is for asthma monitoring. This uses a combination of electronic peak flow meter and a PDA handset which transmits the readings to a central server over a GPRS connection. It also has an integrated monitoring device for diabetics.
Amon is a wrist mounted device which acquires signals such as heart rate, skin perspiration, body temperature etc and transmit these data to a remote tele medicine center. But the vital parameters are not continuously transmitted and inconsistency in the medical data has been reported.
The recording done by these devices must always be analyzed only by a qualified technician or a doctor. This is a huge overhead for the professionals considering the number of patients they attend to in a hugely populous country like India. If you need an immediate diagnosis this approach too proves to be inadequate. In high risk cases you need to make the diagnosis on the fly instantaneously. Hence the wearable device should have sufficient computational intelligence to monitor the heart rate and analyze it dynamically, detect the flaws and immediately inform the care provider. In short, to be of use in a crisis situation the above mentioned devices fail for want of decision support and provision to communicate an alert. And hence the authors propose a new framework which would solve these drawbacks
OUR PROPOSED APPROACH
In this paper we propose a new mechanism for the detection of silent heart attacks and providing an alert... The silent heart attack belongs to the high risk category. Since this does not trigger any visible indications unlike an ordinary heart attack, it could often be fatal and usually goes unnoticed. The only fool- proof method of detecting this is by observing the deviation in the ECG (Electro cardiogram) pattern.
But this data after reception must again has to be analyzed by doctors (which of course is a manual process) in order to make the diagnosis. This could prove to be too slow in dealing with crises like silent heart attacks where an immediate diagnosis and care delivery is of paramount importance. Fortunately computation technology has advanced to provide us with small wearable devices with integrated sensors for cardiac monitoring.
The proposed scheme envisions a wearable diagnostic unit which will continuously monitor the heart checking for abnormality. This is done based on a template matching procedure. Instead of storing the entire pattern it stores the data related to the abnormality alone. The detection generates a trigger signal which is picked up by the patient's mobile phone. And it causes a predefined message to be sent to a predefined number such as the doctor's mobile phone automatically without alerting the patient and causing panic. This communication process can be suitably enhanced like alerting the nearest or any chosen hospital by an automated call.
A simplified diagrammatic representation of the proposed architecture is given below,
The first part is the wearable diagnostic unit and has the following components,
A transducer unit in order to pick up the electrical pulses of the heart.
A conditioner: This will extract the data relevant to heart attack.
Template: The templates will store the reference values with which the output of the conditioner will be matched. The template will be customized to suit the patients' condition based on parameters like age, sex, history of attacks and anonymous conditions. This template will be set based on a doctor's consultation and it can be changed or updated regularly.
Trigger generator: In the case of any abnormality this trigger generator will generate a signal which can be picked up by a mobile phone or PDA so that the alert can be relayed to a care provider.
The second part is the alert unit. This is configured as software installed on the patient's mobile phone or PDA. It listens for the trigger from the wearable unit and upon its receipt executes a routine which will forward a predefined message to a predefined number like the doctor's or that of a trusted medical care provider.
This system will provide an instantaneous analysis and alert which could be vital in saving valuable time and human life. Enhancements like alerting or navigating to the nearest hospital could be added...
Currently the authors are trying to design the wearable diagnostic unit. The design and prototyping of the alert unit has been completed and is being tested by using an explicitly generated trigger signal.
HOW THIS SYSTEM WORKS
This system consists of a hardware and software which are equally important to integrate this device with your mobile phone.
Hardware: This hardware consists of specialized circuit which keeps an eye on the human heart
This hardware is integrated with your pre-existing multimedia mobile phone and when your mobile phone is placed in your shirt pocket then it notes down the rate of heart beat and this hardware is so simple to implement and even for some PDA's and iphones the existing hardware can be used instead of this hardware. iphone, the complete multimedia mobile phone by apple corporation consists of hardware compatible for various features and the hardware installed in the apple iphone does not require any other additional hardware to be installed with.
Software: Basically we know that every hardware is controlled by a software in the same way this hardware is too controlled by a software which consists of all the details of the person's heart beat rate and all the phone numbers of the medical centers of the city. And heart beat rate of the person is firstly assigned in that software and this software which is installed in our mobile phone will monitors all the vibrations of the heart. When once the heart triggers the it checks the rate and if the rate is more or equivalent to the value given in the software then the mobile phone will automatically send a pre-text message to the nearest medical center via SMS. The software recognizes its position by the GPS system and finds out the very nearest medical center and sends a SMS without any help of the person.
This software must be interfaced with the hardware and the technologies of Apple iphone is compatible to use this services just by using its existing hardware, it just needs and additional software to detect the rate of heart beat and to send a SMS.
A prototype has been implemented as a micro controller based system. Trials were conducted using cardiac simulator which can be used as an artificial patient. This equipment can be used to generate the various fault conditions.
The diagnostic unit was implemented around a micro controller which will hold the template database in a code format; the database would allow customization according to the patient's profile. The logic and comparisons are implemented using assembly language coding.
In our experiments we used the Pic18LF452 micro controller. This micro controller has an inbuilt ADC. It also has a UART which can be used for serial communication to the trigger module
A few abnormalities that will trigger the system
First Degree Heart Block Pre Excitation Syndrome
Narrow QRS Complex Tachycardia
Broad Complex Tachycardia
Ypokaliemia, Long QT Syndrome
Depressed Segment Indicating Coronary Ischemia
Long Qt Or Short Qt Syndrome
Efforts are on to design and fabricate a wearable device which can be called an enhanced version of the cardiac holter monitor. An ordinary holter design could be modified and sufficient computational intelligence added to perform a primary diagnosis. The discomfort in wearing the device could be reduced if an RF transmitter could be integrated with the holter.So that we have an "all in one equipment". The usability could be further enhanced if this could be converted into a "System On Chip" solution.
This device is very easy to manufacture, flexible to use where as very useful for the heart patients. So we advice you all to enable this hardware/feature(if you have required hardware) in your mobile phone.