Development and experimentation of atelemedicine solution built around a digital stethoscope. The "BlueHealth" project
Abstract
In this paper, we assess the viability of a solution using a digital stethoscope, together with cordless Bluetooth technology for the comfort of use and the telecommunication means and technology to offer a cost / performance ratio that makes it applicable to Doctor markets (eStetho).We also assess the development of a telemedicine solution: BlueHealth project, in relation with this electronic stethoscope. The described solution allows for: 1) Collection, cleaning and record of physiological data in streaming mode; with primary focus on auscultation sounds for lung and heart analysis; 2) Formatting xml based metadata to carry administrative information related to the patient, to the practitioner, to the device, to the institution, etc., together with physiological data; 3) Transmission of data (protection, confidentiality, access rights, sharing, etc.); 4) Processing (signal processing) of the data for diagnostic help; and 5) Multimedia communication, with audio over IP and display of the record on IPTouch or any other xml compatible device.
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Introduction
Auscultation of a patient’s heart or lungs is part of the Doctor’s professional services [1]. The stethoscope is the emblem of medicine, and yet the tool is of rather poor quality, and the assessment cannot be made remotely. Remote auscultation would improve patient follow-up and clinician-patient interaction. An electronic stethoscope together with signal processing algorithms inherited from the telecommunication world such as echo cancellation, noise suppression, and voice activity detection will make it easy to provide objective analysis of auscultation records and facilitate teaching auscultation [2].
To date, current inhibitors to the widespread deployment of electronic stethoscopes mainly reside on the price (range of $200 to $800), and on quality problems (not solve properly the problem of ambient noise and noise introduced by the sensor head).
In this paper, we assess the viability of a solution using a digital stethoscope, together with cordless Bluetooth technology for the comfort of use and the telecommunication means and technology to offer a cost / performance ratio that makes it applicable to DoctorMarkets (eStetho).
We also assess the development of a telemedicine solution: BlueHealth project, in relation with this electronic stethoscope.
Conclusion
We have developed and experienced a telemedicine solution, called BlueHealth. This described solution, including a digital stethoscope, allows for: -
Collection, cleaning and record of physiological data in streaming mode; with primary focus on auscultation sounds;
Formatting xml based metadata to carry administrative information related to the patient, to the practitioner, to the device, to the institution, etc., together with physiological data that are non-streaming with a first set of medical parameters;
Transmission of data (protection, confidentiality, access rights, sharing, etc.),
Processing (signal processing) of the data for diagnostic help,
Multimedia communication, with audio over IP and display of the record on IPTouch or any other XML compatible device.
Market targets are medical application of information sharing and consultation (Medical Staff meetings, training). Such approach remains relevant in Emergency situation where remote transmission from crisis area to emergency service may allow “pre care/ pre-processing” of the patient issue together with transmission of physiological parameters measurement between emergency team and hospital desk.
The following components need to be added to the existing prototype of our telemedicine solution to go to the market: -
Security (authentication, encryption, authorization…) for local and remote database access;
Certification (US [FDA], Europe [EMEA], France [ANSM]);
PRS robustness: Windows last version of the PRS goes down following quick multiple presses on a key; we have developed a dll that avoids PRS crash, but this makes a specific version of PRS. This bug should be corrected in the generic version of the PRS.