Doctoring from a distance

Medical monitoring devices make health care more efficient, less invasive

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Gill Tsouri

Before seeing a physician in the emergency room, a patient’s pulse and blood pressure will be taken even though no electrodes or wires will be connected to that patient.

This is the emergency room of the future, and the technology being developed to monitor patients, well before being seen by attending staff, will soon become a fundamental part of triage.

Preliminary assessment of a person’s vital signs, done remotely through video streams, sensors and wireless technologies, can be the answer for efficiently moving patients from busy waiting rooms to medical personnel for care, says Gill Tsouri, an assistant professor of electrical engineering.

His work on non-invasive medical monitoring devices is being developed to take standard vitals such as pulse, temperature, blood pressure, breathing rate and oxygen levels. It can mean time better spent with medical personnel on diagnosis and intervention.

“When you go into an emergency room or other department in a hospital, it takes more than 7-10 minutes to get your vitals. Imagine if 20 patients are in that waiting room? That is a bottleneck,” says Tsouri. “What if you can take measurements automatically on the guy just sitting, waiting for his turn to see a physician?

“We are going to do as much of the triage as possible, based on non-contact video streaming. We are not the first to do this, but we have ideas of making it more accurate.”

Using a video stream from a standard camera placed at strategic locations in an emergency room, data is captured and distilled through independent component analysis, a process that identifies underlying statistical behaviors, properties or structures.

Tsouri worked with Sohail Dianat, department head of RIT’s electrical and microelectronic engineering; Lalit Mestha, a scientist at Xerox Corp.; and graduate student Survi Kyal, to develop an algorithm based on this process that takes the data supplied by the camera and sensor, transfers it to a central database through wireless technologies and provides an accurate reading of an individual’s pulse. This process could eventually replace the small finger monitor now used in hospitals.

Distinguishing one person from another in a waiting room is a solvable challenge, he adds. Using facial-recognition software and combining it with the bio-medical sensor technology, staff can obtain accurate patient information.

Tracking software to allow for an individual’s movement while the sensor is picking up vital signs will also be incorporated. The team is also assessing how incandescent or florescent lights and even reflections off a person’s glasses might affect the data.

The project, sponsored by Xerox Corp., is part of a corporate research and development agreement. The application in development could have multiple uses such as in neo-natal units or at airport security checkpoints to detect signs of illnesses like SARS or passengers in distress.

Body Sensor Network Technology

The prototype device for wireless electrocardiogram systems using sensor nodes was built in the Communications Lab in the electrical and microelectronic engineering department. The device uses half the amount of leads, or wires, found in the traditional ECG system, yet early testing is showing comparable accuracy.

“The 12 leads have some redundant operation because they are looking at the heart from different angles and the question has been asked, ‘if you can capture the same amount of data using a reduced number of leads, how many leads do you actually need to have meaningful information?’ says Michael Ostertag, an electrical engineering graduate student and part of the project team. “The project is to record an ECG wirelessly and using a reduced number of devices. In addition, it helps reduce electrode misplacement as well.”

Ostertag, along with Kendell Clark, Nikhil Argade and Alvaro Prieto, all graduate students of electrical engineering, built the hardware at RIT.

While intended for use in hospitals, medical facilities or even at a patient’s home by on-site caregivers, the application can be used to remotely assess soldiers on the battlefield.

RFID Technology Monitors Hand-Washing Compliance

Viruses, bugs, illnesses. Sometimes hand washing and general hygiene can prevent their spread. In hospital settings, this is essential. Rochester General Hospital System has piloted a program to decrease the incidence of infections transmitted between patient and staff using human know-how and a familiar asset tracking technology, RFID tags, or radio frequency identification.

RFID tags are being used as part of a monitoring program to ensure adherence to guidelines for hygienic practices at the hospital. Placed on medical staff name badges, the tags record each time an individual enters a patient’s room and uses the sanitary wash-gel. The RFID tag logs the “transaction.” Upon approaching a patient, the tag is triggered once again, identifying the staff member.

“This has been in place in a single RGH room so far,” says Tsouri, who worked on the project with Dr. Edward Walsh, head of the infectious diseases unit at RGH. The purpose of the project is to build a database to be used for assessing compliance rates and correlating those with the spread of diseases in the hospital.

E-Health Intelligence Systems

A small device design was big enough to earn acclaim for a group of computer engineering students.

The students were grand-prize winners for their E-Health Intelligence System at the Freescale Technology Forum Make It Challenge event this summer. It was the first time the RIT team had entered the national contest and it won its category as well as the overall grand-prize of $3,000 and a VIP weekend at a NASCAR event.

The system is a health-monitoring device, small enough to fit in a patient’s pocket, and the data can be accessed anywhere in the world by physicians, says Daniel Cheung, a member of the project team.

The E-Health Intelligence System is a low-power mobile device that can collect different vital signs such as heart rate, respiration information or EKG data. It consists of a network of sensors and wireless receivers that can monitor patient vitals and transmit this information to doctors. Physicians would be able to access this medical data in real time from an Android phone or a tablet computer, improving access outside of a clinical or hospital environment.

The project team of Cheung, Daniel Liu and Sam Skalicky are all students in computer engineering program in the Kate Gleason College of Engineering. Contestants were required to use at least one of Freescale’s controller hardware modules for the prototype design. Projects were judged on creativity, innovation, design efficiency and commercial suitability.

The team expects to continue development, add additional functionality and present the prototype to physicians groups that have shown interest in the product.