Developing a Practical Wearable Developing a Practical Wearable Telemedicine SystemTelemedicine System

for Emergency and Mobile Medicinefor Emergency and Mobile Medicine

Martin Dudziak, PhD Tamara Koval, MD

Medical College of Virginia

and

Silicon Dominion Computing, Inc.

November 22, 1998

2

Presentation Outline

• Mobile Telemedicine– Issues and Motivations

• Requirements and Demands

• Mobile Wearable PCs

• TransPAC and MediLink

• Methods for Testing and Evaluation

3

Issues and Motivations for Mobile Telemedicine

• Increased mobility of general population

• Decreased centralization of health services

• Expansion of electronic medical records

• Increased use of imaging and video

• Need for more remote/home health care

• Increased role of assistant-level staff

4

Effective Mobile Medical Communications: Requirements

• Convenient

• Common Standards

• Interoperability

• Upgradeable

• Customizable

• Interchangeable

• Secure

5

Mobile Wearable PCsfor

Patient Data Access and Acquisition

• Evolution in Computing Platforms

• Maturation in Telecommunications

• Advances in Data Compression

• Availability and Readiness of Data

• Advances in Security, Power, and Storage

6

Three Examples

7

Pros and Cons of the Wearable PC

• Full PC features, compatibility• Lightweight, convenient to carry• Speech, pen, keyboard, mouse inputs• Internet-capable; large memory, storage capacity• Expensive• Dangling wires and parts• Hardware and speech quirks• Not user-friendly for general population

8

Current and

Projected Medical Enterprise

Data Systems

Practical speech,smart card, video,

intranet functionality

AdaptableErgonomic

Wearable PC

TransPAC with MediLink

TransPAC Alternative Integrated Approach

9

A Systems Engineering Approach to Telemedicine

• Mobile network emphasizing seamless communication for data and voice

• Medical process and flow continuity: Enhance, do NOT disrupt

• Adapting to institutional data management and “IT” structures, not demanding alternatives

• RequirementsSpecifications Design RAP / RAD Implementation

10

• Modular and wearable PC (Windows95/98)• High-end graphics and video features and

extensibility (128MB+, 200MHz+, 2 GB+)• Speaker-independent and speaker-custom speech

recognition• Wireless Internet modem• Direct link with image and database servers• Smart card for access and transaction registry

TransPAC Mobile Computing Platform

11

Beltpack or Bodypack

Carrying Unit

CRT or LCD

Display

Base System Unit

Extension Pack

Microphone

Headphones

Cell Phone

WirelessModem

Battery Pack

AC PowerAdapter

Kbd / Mouse

RS232 Data Acquisition Device(s)

Parallel Data Acquisition Device(s)

PCMCIA Data Acq Device(s)

CD/DVD/Tape Unit

12

Testing/Engineering/Maintenance System Databases

(typical scenario: ModelServer Discovery with connectivity to Oracle databases)Field Office/ Lab

PC(Base Station)

Card Reader

Active Session Card

1

2Task dataset loaded onto Active Session Card in Base Station PC

Wearable PC with CardReader built-in or as plug-in (PCMCIA interface)

Active Session Card

3

In-field data collection process; data processed on PC and stored on Active Session Card

4Work completed and Active Session Card time-stamped and ready for upload through BASE station

5

Voice input

Internet access

Camera or video (MAGVISION)

Keyboard/ mouse/pen input

GPSActive Session Card

6Active Session Card returned to Base Station PC for upload

TransPAC Function and Data Flow

13

TransPAC Internal Data ModelPTR (Primary Transaction Record)

FIELD VALUEUnique key alphanumeric stringUser-ID alphanumeric stringTCR Field List alphanumeric string; field pointers

separated by delimitersJobstart date/timeJobend date/timeoptional other task-defining fields (optional)

TCR (Transaction Content Record)FIELD VALUE CONTENTPTR key alphanumeric string pointer to the associated PTR recordfile list linked list; e.g. (see below) (link/field ID + file pointer + locator in file) --- link/field1 text memo in MEMO.XXX, loc 001 --- link/field2 still photo in PHOTO1.YYY --- link/field3 text memo in MEMO.XXX, loc 002 --- link/field4 sketch in DRAW01.ZZZ --- link/field (n) video clip in VID01.XXX

14

• Patient-oriented application session and auto-managed files and folders

• Freeform Writing Pad with graphic and video options (cut-and-paste and links)

• Patient-oriented distributed database access protocol

• BodyMap graphic interface for patient records• Standard internet browser functions• Multimedia data acquisition & imaging functions

MediLink Key Features

15

MediLink Application

16

17

newsession folder

new_session.htm

header file

jgsmythe-243-67-9631 folder

jgsmythe-243-67-9631.htm

header file

Enter new patient basic data

jgsmythe-243-67-9631 folder

jgsmythe-243-67-9631.htm

header file

Download from server, enter notes, drawings, capture video, EKG, other data

Store on server, session card, hard drive

SESSIONDATAFLOW

18

19

On-Board Interactive Assistance

• Speech-to-Text-to-Database• Customized speaker-independent

vocabularies for command, control, entry• Patient record pointers eliminate searching,

keystrokes, commands• Image comparison and differentiation tool

for real-time image analysis

20

21

Wireless Intranets

22

Wavelet-Based Image Compression

Fetal faceUltrasound 72K 50:1, 7K 125:1, 2K

Huntington’s MRI+SPECT overlay 44K 100:1, 7K 200:1, 4K

23

Adaptive Pattern Recognition - Like Humans Do It

Beginning of recognition process Later stage of recognition process

24

Another Example - Cutting Through the Noise

Beginning of recognition process Later stage of recognition process

25

Acknowledgements

• Slava Vaseken, Silicon Dominion– TransPAC Design Team

• Interactive Solutions, Inc.• Bentley Systems, Inc.