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1、BioMed CentralPage 1 of 12(page number not for citation purposes)BioMedical Engineering OnLineOpen Access Research Multi-purpose HealthCare Telemedicine Systems with mobile communication link support E Kyriacou*1,2, S

2、Pavlopoulos1, A Berler1, M Neophytou1, A Bourka1, A Georgoulas1, A Anagnostaki1, D Karayiannis3, C Schizas2, C Pattichis2, A Andreou2 and D Koutsouris1Address: 1Biomedical Engineering Laboratory, Department of Electric

3、al and Computer Engineering, National Technical University of Athens (NTUA), Athens, Greece, 2Department of Computer Science, University of Cyprus (UCY), Nicosia, Cyprus and 3Athens Medical Center (AMC), Athens, Greece

4、Email: E Kyriacou* - ekyriac@ucy.ac.cy; S Pavlopoulos - spav@biomed.ntua.gr; A Berler - berler@biomed.ntua.gr; M Neophytou - mneoph@ucy.ac.cy; A Bourka - abourka@biomed.ntua.gr; A Georgoulas - ageorg@biomed.ntua.gr; A

5、Anagnostaki - angiea@biomed.ntua.gr; D Karayiannis - dikar@iatriko.gr; C Schizas - schizas@ucy.ac.cy; C Pattichis - pattichi@ucy.ac.cy; A Andreou - aandreou@ucy.ac.cy; D Koutsouris - dkoutsou@biomed.ntua.gr* Correspondi

6、ng author Emergency Health CareTelemedicineGSMSatelliteAbstractThe provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rura

7、l Health Centers (RHC) or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important i

8、ssues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile) unit. Th

9、is integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive

10、health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's h

11、ome while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp) and still images of the patient. The transmission i

12、s performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can tele

13、matically “move“ to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine

14、 sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunica

15、tion means; in addition the system has been clinically validated in three different countries using a standardized medical protocol.Published: 24 March 2003BioMedical Engineering OnLine 2003, 2:7Received: 30 November 200

16、2 Accepted: 24 March 2003This article is available from: http://www.biomedical-engineering-online.com/content/2/1/7© 2003 Kyriacou et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying

17、 and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.BioMedical Engineering OnLine 2003, 2 http://www.biomedical-eng

18、ineering-online.com/content/2/1/7Page 3 of 12(page number not for citation purposes)monitoring can solve this problem by enabling experi- enced neurosurgeons, cardiologists, orthopedics and oth- er skilled people to be v

19、irtually present in the emergency medical site. This is done through wireless transmission of vital biosignals and on scene images of the patient to the experienced doctor. A survey [17] of the Telemedicine market states

20、 that emergency Telemedicine is the fourth most needed Telemedicine topic with 39.8% coverage of market requests while home healthcare covers 23.1%. The same survey also points out that the use of such state of the art t

21、echnologies has 23% enhanced patient outcomes.Several systems that could cover emergency cases [18]- [23], home monitoring cases [24]-[25] and critical care te- lemetry [14] have been presented over the years. Recent dev

22、elopments in mobile telecommunications and infor- mation technology enhanced capability in development of telemedicine systems using wireless communication means [26]-[32]. In most cases however only the store and forwar

23、d procedure was successfully elaborated, while the great majority of emergency cases do require real time transmition of data.In order to cover as much as possible of the above differ- ent growing demands we created a co

24、mbined real-time and store and forward facility that consists of a base unit and a telemedicine unit where this integrated system:? Can be used when handling emergency cases in ambu- lances, RHC or ships by using the Tel

25、emedicine unit at the emergency site and the expert' s medical consulting at the base unit? Enhances intensive health care provision by giving the telemedicine unit to the ICU doctor while the base unit is incorporat

26、ed with the ICU' s in-house telemetry system? Enables home telemonitoring, by installing the telemed- icine unit at the patient' s home while the base unit re- mains at the physician' s office or hospital.The

27、 Telemedicine device is compliant with some of the main vital signs monitor manufacturers like Johnson & Johnson CRITIKON Dinamap Plus and Welch Allyn – Protocol (Propaq). It is able to transmit both 3 and 12 lead EC

28、Gs, vital signs (non-invasive blood pressure, tem- perature, heart rate, oxygen saturation and invasive blood pressure) and still images of a patient by using a great va- riety of communication means (Satellite, GSM and

29、Plain Old Telephony System – POTS). The base unit is com- prised of a set of user-friendly software modules that can receive data from the Telemedicine device, transmit infor- mation back to it and store all data in a da

30、tabase at the base unit. The communication between the two parts is based on the TCP/IP protocol. The general framework forthe above system was developed under EU funded TAP (Telematics Applications Programme) projects,

31、the EMERGENCY 112 project(HC 4027)[33] and the Ambu- lance project(HC1001) [22].Methods Trends and needs of Telemedicine systems As mentioned above, scope of this study was to design and implement an integrated Telemedic

32、ine system, able to handle different Telemedicine needs especially in the fields of:? Emergency health care provision in ambulances, Rural Hospital Centers (or any other remote located health center) and navigating Ships

33、? Intensive care patients monitoring? Home telecare, especially for patients suffering from chronic and /or permanent diseases (like heart disease).In other words we determined a “Multi-purpose“ system consisting of two

34、major parts: a) Telemedicine unit (which can be portable or not portable depending on the case) and b) Base unit or doctor' s unit (which can be port- able or not portable depending on the case and usually lo- cated

35、at a Central Hospital).Figure 1 describes the overall system architecture. In each different application the Telemedicine unit is located at the patient' s site, whereas the base unit (or doctor' s unit) is locat

36、ed at the place where the signals and images of the patient are sent and monitored. The Telemedicine device is responsible to collect data (biosignals and images) from the patient and automatically transmit them to the b

37、ase unit. The base unit is comprised of a set of user-friendly software modules, which can receive data from the Tele- medicine device, transmit information back to it and store important data in a local database. The sy

38、stem has several different applications (with small changes each time), ac- cording to the current healthcare provision nature and needs.Before the system' s technical implementation, an over- view of the current tre

39、nds and needs in the aforemen- tioned Telemedicine applications was made, so that the different requirements are taken into account during de- sign and development, thus ensuring maximum applica- bility and usability of

40、the final system in distinct environments and situations. Table 1 provides the results of this overview, which was done towards a predefined list of criteria that usually influence a Telemedicine applica- tion implementa

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