4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Healthcare Research Focus at Xerox Research Center India
• Non-contact video-based detection of body vitals and diseases
• Decision support for clinicians - diagnosis, prediction, treatment options for diseases
Acknowledgements: Lalit K Mestha, Xerox Fellow; Manipal Hospital
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
How Deep Can We See?
Mean optical path length for 500 - 650nm = ~1-2mmMean optical path length for NIR (700 – 2400nm) = ~6-10mm
Blood pool in a normal skin is at ~0.3 – 2mm deep
Epidermis: 0.06– 0.5mmDermis: 1-4mmHypodermis: 1 – 6mm
Thickness of skin layersMean Optical Path Lengths & Penetration Depth
Ref: JHGM Klaessens and RM Verdaasdonk, “Non-invasive skin oxygenation imaging using a multi-spectral camera system: Effectiveness of various concentration algorithms applied on human skin”, Proc. Of SPIE Vol. 7174 717408-1, 2009
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Video based Detection – in progress1. Non-contact vitals (continuous monitoring)
– Heart rate– Respiration rate– Temperature– Oxygen saturation (functional & fractional)– Pulmonary volumes with 3D– Heart rate variability– Blood pressure– Glucose
2. Disease diagnostics– Cancer screening (melanoma, breast cancer, ..)– Cardiac arrhythmias (atrial fibrillation, premature atrial contraction etc)– Strokes, diabetics etc.,– Abnormalities in a comprehensive metabolic panel (CMP) etc– Sleep apnea– SIDS
3. Biometrics– Vein pattern & cardiovascular based biometrics
4. Food volume & nutrition content detection
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Monitoring Respiration, Temperature
Research Problems
Algorithms for continuous monitoring & Data Fusion with multiple cameras
Respiration signal
Temperature signal
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Health: Cardiac Arrhythmia (A-fib) DetectionXerox Camera
Work process:1. Patient with A-fib enrolled for the study2. Videos were taken of the entire process of electrical
cardio version3. Holter monitor installed4. Patient - briefed about the benefits of the study5. Patient – undergoes electrical cardio version6. Patient – cleared of A-fib
Performed video shoot of A-fib patients interacting with Doctors, nurses and patients
461 462 463 464 465 466 467 468
-3
-2
-1
0
1
2
3
Time (in secs)
Normal
ized Am
plitude
Raw ECG v/s PPG extracted using video camera
ECG lead 2PPG (from video)
Irregular beat to beat intervals
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
A-fib Detection – During A-fib (Patient 1)
409 410 411 412 413 414 415 416 417
-2
-1
0
1
2
3
4
494495
496497 498
499 500501
502503
504505 506 507
50850
time (in secs)
Norm
aliz
ed A
mpl
itude
ECG vs PPG
ECG (lead 2)PPG (video)peaks (ECG)peaks (PPG)
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
A-fib Detection–Normal Sinus Rhythm (Patient 2)
843 844 845 846 847 848 849 850 851 852 853
-2
-1
0
1
2
3
900
901902
903904
905 906 907908 909
910 911 912
time (in secs)
Norm
aliz
ed A
mpl
itude
ECG vs PPG
ECG (lead 2)PPG (video)peaks (ECG)peaks (PPG)
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Sample Data Collection on Cancer Patients• Patient 2: Male Patient
Mammogram Images Thermal Images
Right breast Left breast Left breast
Confirmed malignant lesion(2.5 x 1.3 cm in the left breast)
Craniocaudal and mediolateral oblique views ~45 deg right from sagittal plane
Along sagittal plane
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Sample Data Collection on Cancer Patients• Patient 3: Female Patient
Mammogram Images Thermal Image
Right breast Left breast
No suspicious region foundNo cancer found. Radiology report suggestedFibroadenoma – a benign lesion
~45 deg right from sagittal plane
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Sample Data Collection on Cancer Patients• Patient 4: Female Patient
Mammogram Image
Left breast Malignant lesion
Sonomammogram Image
~10 deg right from sagittal plane
Cancer is spread to lymph nodes
~45 deg right from sagittal plane
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Healthcare Research Focus
• Non-contact video-based detection of body vitals and diseases
• Decision support for clinicians - diagnosis, prediction, treatment options for diseases
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Emergency Room Decision Support: Stroke Prediction
Stroke happens when blood flow to a part of the brain stops, often causing permanent damage
• 4.4 million deaths each year.• ~70% of the strokes are first-ever
strokes
Tools for Clinical decision support, Preventive healthcare
Open Innovation Project with Indian hospitals• Data collection initiated• Initial statistical model for stroke severity
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Open Healthcare Analytics System
AnalyticsData & Process Analytics
• Risk Models• Diagnostics
• Treatment planning• Preventive Healthcare
Data
Providers,Others
Clinical/patient dataProcess dataGene banks
ML researchersUniversitiesCrowd Experts
Abstracted Data Views
Analytical Models
External Partners
Data Integration andPrivacy Management
Reporting& Visualization
Adapters: integrate with EHR/HIS solutions
Open APIs
Medical LiteratureWebsites
Social networks