Dispositivi bio-elettronici:sensori per la salute e il benessere

STMicroelectronicsFestival dell’Innovazione

Bari, 1 Dicembre 2010

Andrea Vitali

andrea.vitali@st.com

Outline

STMicroelectronics company presentation

MEMS sensors

MEMS biomedical systems

Remote monitoring: scientists and patients needs

The wearable unit “BODY GATE WAY”

Other Devices (holters, patches, bracelets)

2

STMICROELECTRONICSCompany Presentation

3

STM: bio-electronics

Lab on chip

In-vitro analysis

Wearable bio-electronics

In-vivo analysis

ST hardware and software

5

Electrocardiogram

Bioimpedance

Acceleration

Phonocardiogram

Photoplethysmogram

Temperature/heat flux

Linear components

Linear components

MEMS acc/gyro

MEMS microphone

MEMS accelerometer

CMOS camera

SPAD

Linear components

MicrocontrollersRadio modules

FirmwareProcessing IPs

Heart rate, beat classification,

blood analytes from morphology,

metabolic activity

Heart/breathing rate, fluids,

stress, glucose level

Body position/activity, gait analysis,

fall detection (with barometer)

Heart/breathing rate, blood pressure

(alone or with electrocardiogram)

Heart rate, blood analytes, blood

pressure (with electrocardiogram)

Metabolic activity

MEMS SENSORSAccelerometers, Gyroscopes, Pressure sensors, Microphones…

6

STM: silicon and beyond

Micro sensors

Micro Electro Mechanical Systems

(MEMS)

Microelectronics

Systems on a Chip

(SoC)

Low-power fault-tolerant processing/memory

Analog-to-digital input, power output

Wireless

Accelerometers, Gyroscopes

Pressure sensors, Microphones

Micro Electro Mechanical Systems

+ =

ASICMEMS

Stacked dual-die configuration

Dedicated package and calibrationMicron-sized transducer Analog Front End

Transducer: from linear/angular acceleration to diff C charge, micro-machining (THELMA process)Front-end: from diff C charge to output V, high performance with embeddded trimming features

advantages• low-cost smaller package• faster time-to-market

Accelerometer/Gyroscope Transducer

+moving

mass

Fixed

Moving

C1 C2

C1, C2 varying capacitanceAccelerometer for Linear acceleration

Gyroscope for Angular acceleration

Linear acceleration

Linear acceleration

Angular acceleration

Coriolis motion

Imbalanced variation

C1> C1’ C2 < C2’Balanced variation

C1=C1’ C2=C2’

Vibrating masses

moving mass

Vibrating masses

C1 C2

C1’ C2’ C2’C1’

C1 C2

Coriolis motion

Accelerometer Portfolio3x3mm (2x2mm in 2010), dual/tri axis, analog/digital output

selected

selected

Gyroscope Portfolio5x5mm, yaw single/dual axis pitchroll-pitchyaw, analog output

sta

bili

zer

In-plane axis: pitch, rollOut-of-plane: yaw

selected

MEMS BIOMEDICAL SYSTEMSMEMS sensors and bio-electronic system

12

Vital sign detection

13

Implantable sensors/actuators

14

Medtronic

Diabetes management: nanopump

15

ST and Debiotech

Small, precise and safe

Glaucoma: pressure monitor in contact lens

16

ST and SensiMed

Lab-on-chip: real-time DNA/RNA analysis

17

Congestive heart failure: electronic patch

18

ST and Mayo Clinic

REMOTE MONITORINGThe need for wearable devices

19

Long term trend

Remote monitoring context

20

DiseasesRisk factors

Cannot be modified

Aging

Genetics

Can be modified

Bad diet

No/low physical activity

Smoking

Ambient, socio-economic factors

Aging of population

Globalization

Urbanization

Overweight -obesity

Hypertension

Hyperglycemia

Blood anomalies

Common

Diabetes

Cardiac pathologies

Ictus

Tumours

Breathing anomalies

Chronic

The need of…

21

The need of the Scientist

• Heart electric signal (ECG) …holters (1-3-8-12 leads)

• Heart sounds …digital stethoscopes

• Breathing activity …chest bands

• Blood Oxygen (SpO2) …photoplethysmographs (PPG)

• Blood pressure (mmHg) …pressure cuff

• Blood glucose …invasive

• Body temperature

• Body activity/position

• …

The need of…

22

The need of the ScientistThe need of Patients

Need for comfortable wearable devices to enable remote monitoring and care: micro detectors and micro infusion pumps

This future? or this?BodyGateWayConfinement, discomfort…

Rare but significant events are not captured during short visits

Long term monitoring do capture all events

Without remote monitoring

24

Healty At risk No symptoms Symptoms

Check up

Hospital

Visit

With remote monitoring

25

Healty At risk No symptoms Symptoms

Life Style Control Early

detectionHome

point of care

Symptoms

(today in hospital)

No symptoms

(today not treated)

At risk

(genetics, aging, bad diet, no/low activity, smoking..)

Healthy

Early detection on large scale

Comfortable remote monitor

Life style control (fitness)

Remote monitoring applications

Our target

Other possible targets

THE WEARABLE UNIT“BODYGATEWAY”

27

Miniaturized, portable, wearable devices

BodyGateWay

Mobile

Components maker (STM)

Device manufacturer (NOKIA)

Service provider (VODAFONE)

:

First prototype (2008)

Desired features

• Wearable

• non invasive

• easy-to-use

• low cost

• ...

First prototype 2010

30

• long term monitoring• multi parameter monitoring• automatic classification (intelligence)

• low cost for large scale• comfort for long term use• robustness for every day life• easy to use for common people

Storage

User PC Doctor PCCare provider

BodyGateWay Mobilephone

Internet

scale

cuff

BodyGateWaySystem overview

Main screen

• Body activity

• Heart Rate

• Breathing Rate

• Battery level

ECG screen

Raw ECG signal

Symptoms screen

Patient is prompted

Mobile touch interface

Device block scheme

Accelerometer(Gyroscope)

Electrogram Bioimpedance

Phono

Cardio

Gram

Electro

Cardio

Grammuscles

activity

fusion

Imped.

Cardio

Gram

body

activity

position

Breath

Rate

Fluids

Pressure

Glucose

Examples of fusion:

• Reliable heart rate by combining all cardio grams

• Does heart rate match physical activity?

• Active noise cancellation of motion artifacts

• …

Signals and parameters• ECG: Heart beats, heart rate

• ICG: Breathing rate

• XYZ: Body position, body activity

Device block scheme

Microphone(Accelerometer)

Phono

Cardio

Gram

Red/IR LED

+ PD/CMOS

Photo

Plethysm

Gram

SpO2

CO/CO2

Bilirubin

Pressure

Breaths

Pressure

Temperature

Heat Flux

Meta

bolic

activity

AMBIENT Temp, Press, Sounds, Light, Hygro, Smoke, CO…

Other signals• Blood oxygen (PPG)

• Blood pressure (PCG/PCG/PPG, +ECG)

• Glucose level (ICG/ECG/PPG Raman)

• …

Accelerometer(Gyroscope)

Electrogram Bioimpedance

Phono

Cardio

Gram

Electro

Cardio

Grammuscles

activity

fusion

Imped.

Cardio

Gram

body

activity

position

Breath

Rate

Fluids

Pressure

Glucose

Impact on existing infrastructure

35

Need for changes

• Data storage and processing

• Emergency / support call centers

• Different admission / dismission protocols

• Medical staff / patient training

• …

Critical issues

(crying wolf/bomb penalty)

• Cost of false pos/neg: does it saves lives?

• Cost ($$$): does it save money?

• Time: does it save time?

Can it be used in the real world?

Is it worth using?

Smart ECG processing

good easy signal disconnected electrode

muscle noise

motion artifacts

Premature ventricular contractions

Premature atrial contractiondeep breathing

paced beats Supraventricular tachycardia

SignalsAccelerometerElectrogram

Walking up/down stairsDriving in car Sleeping (2 hrs) Gym session

BreathsHeartbeats Walking Heartbeats (after 1 hr)

ECG

Z0

Heartbeats from ECG and accelerometer.

Breaths from ECG (R peak amplitude modulation) and accelerometer.

Steps can be counted from accelerometer.

After 1 hour ECG signal is affected by high-freq noise.

Low activity when sitting in car and driving.

High activity when walking up/down stairs.

No activity. Body position can clearly be seen.

ECG is good even while exercising in the gym.

Breaths

ECG ECG ECG

ECG ECG ECG

XYZ XYZ

DZ DZ

Litres (spirometer)

XYZ

XYZ

XYZ

Bioimpedance

ECG

Z0

DZ

ECG

DZ

DZ vs spirometer

Breaths/min

WalkingBreathing and holding (zoom on held breath) DZ vs spirometer

XYZ

XYZ

Heart beats

Signals

Red 12bits 100Hz

Infrared 12 bits 100Hz

ECG

Photodiode on finger, reflective mode.

Photodiode on finger, reflective mode.

Optical 8bits 20x20 150fps

Microphon placed on neck

Microphone placed on chest

Microphone placed on chest, coughing

Artifacts caused by slipping mic.

MicrophoneRed/IR led

+ Photodiode

Microphone placed on wrist

Microphone placed on arm

Heartbeats Heartbeats Heartbeats Heartbeats …and coughs …and noise

ECG

CMOS camera (optical mouse), transmissive mode.

Photodiode on wrist, reflective mode.

Photodiode on chest, reflective mode.

ECG ECG ECG

red red red

infrared infrared infrared

Heartbeats Heartbeats

R&D• broad spectrum LED can be compensated

• inexpensive camera gives slipping motion for active noise cancellation

• two infrared LEDs for black skin with melanin